Zhao Yu-Kun, Wang Fang, Chen Wen-Na, Xu Rui, Wang Zhuo, Jiang Yuan-Wen, Luo Di-Qing, Han Jian-De
From the Department of Dermatology (Y-KZ, FW, W-NC, RX, ZW, D-QL, J-DH), The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, China; and Department of Dermatology (Y-WJ), Affiliated Hospital of Youjiang Medical University for Nationalities, Baise, China.
Medicine (Baltimore). 2016 Apr;95(16):e3429. doi: 10.1097/MD.0000000000003429.
Lupus erythematosus panniculitis (LEP) is a variant of chronic cutaneous lupus erythematosus (CCLE). Reported cases of LEP lesions before the diagnosis of systemic lupus erythematosus (SLE) were very rare; only 9 cases have been reported, to the best of our knowledge. We now describe the case of a 19-year-old male patient, with an overall review of the English literature. In the earliest stage of the present case, nodules and ulcers involved his left leg and face, with no other accompanied symptoms. The skin lesions disappeared after treatment with methylprednisolone, 16 mg/d for 1 month. Seven months after discontinuing methylprednisolone, the cutaneous nodules and ulcers on his back recurred and were accompanied by fever, hair loss, and polyarthritis. Blood tests revealed leucopenia, positive antinuclear antibody and Smith antibody, and proteinuria. Histopathological findings were most consistent with LEP. This was followed sequentially by the diagnosis of SLE. The patient improved again after treatment with methylprednisolone and cyclophosphamide.Patients with LEP should have regular follow-ups because the development of SLE is possible. Early diagnosis and proper treatment is pivotal to improve the prognosis of such patients.
红斑狼疮性脂膜炎（LEP）是慢性皮肤型红斑狼疮（CCLE）的一种变体。在系统性红斑狼疮（SLE）诊断之前报告的LEP病变病例非常罕见；据我们所知，仅报告了9例。我们现在描述一名19岁男性患者的病例，并对英文文献进行全面综述。在本病例的最早阶段，结节和溃疡累及他的左腿和面部，无其他伴随症状。用甲泼尼龙16mg/d治疗1个月后，皮肤病变消失。停用甲泼尼龙7个月后，他背部的皮肤结节和溃疡复发，并伴有发热、脱发和多关节炎。血液检查显示白细胞减少、抗核抗体和史密斯抗体阳性以及蛋白尿。组织病理学结果与LEP最为一致。随后依次诊断为SLE。患者在用甲泼尼龙和环磷酰胺治疗后再次好转。LEP患者应定期随访，因为有可能发展为SLE。早期诊断和适当治疗对于改善此类患者的预后至关重要。
