Berger Emily, Robinson Maria, Patel Rishi, Franks Andrew G
The Ronald O. Perelman Department of Dermatology, New York University School of Medicine, USA.
Dermatol Online J. 2012 Dec 15;18(12):17.
A 63-year-old woman with a ten-year history of systemic lupus erythematosus presented with a three-year history of a large, pruritic lesion that was located on the back and a pruritic lesion that was located on the right thumb. She was a baker by profession for many years during which time she often stood with her back to a hot oven. Physical examination of the lower back showed a large, atrophic, and reticulated plaque with a hyperpigmented border. On the right thumb was a well-demarcated, erythematous plaque with adjacent loss of the medial nail plate on the affected finger. Histopathology of both skin lesions showed cutaneous lupus erythematosus. This patient displays the Koebner phenomenon to heat in cutaneous (discoid) lupus erythematosus. We propose the term lupus ab-igne to describe her skin lesions. There are a few reports of the Koebner phenomenon occurring in patients with lupus erythematosus in response to contact dermatitis, tattoos, zoster, operative scars, scratching, or pressure from clothing. To our knowledge, this is the first report of heat as the physical factor leading to the formation of cutaneous lupus lesions.
一名有10年系统性红斑狼疮病史的63岁女性，出现了一个位于背部的、有三年病史的巨大瘙痒性皮损，以及一个位于右手拇指的瘙痒性皮损。她从事面包师职业多年，在此期间她经常背对着热烤箱站立。下背部体格检查显示一个巨大的、萎缩性的、网状斑块，边界色素沉着。右手拇指有一个边界清楚的红斑性斑块，受累手指的内侧指甲板相邻处缺失。两个皮肤损害的组织病理学均显示皮肤型红斑狼疮。该患者在皮肤（盘状）红斑狼疮中表现出对热的同形反应现象。我们提出“火激红斑狼疮”这一术语来描述她的皮肤损害。有一些关于红斑狼疮患者因接触性皮炎、纹身、带状疱疹、手术瘢痕、搔抓或衣物压力而出现同形反应现象的报道。据我们所知，这是关于热作为导致皮肤狼疮损害形成的物理因素的首次报道。
