García-Arpa Mónica, Rodríguez-Vázquez María, Bellido-Pastrana David, Villasanti-Rivas Natalia, Carmona-Rodríguez Marcos
Department of Dermatology, Hospital General Universitario de Ciudad Real, Ciudad Real, Spain.
Department of Dermatology, Hospital General Universitario de Albacte, Albacete, Spain.
Eur J Case Rep Intern Med. 2020 Feb 12;7(3):001462. doi: 10.12890/2020_001462. eCollection 2020.
Manifestations of chronic cutaneous lupus erythematosus are variable. Periorbital and facial swelling occurs in dermatomyositis and systemic lupus, but it has been rarely reported as a manifestation of exclusively cutaneous lupus. A 48-year-old woman presented with a 16-year history of asymptomatic, bilateral swelling and erythema of her face with marked worsening after sun exposure. No systemic symptoms were associated. A complete evaluation did not reveal other findings. Cutaneous biopsy showed features of lupus erythematosus. She was treated with photoprotection, topical tacrolimus, hydroxychloroquine and azathioprine with a partial response. Facial swelling with erythema represents quite an unusual manifestation of chronic cutaneous lupus erythematosus. Dermatomyositis, systemic lupus and Morbihan disease are the main differential diagnoses.
Periorbital and facial swelling with erythema are clinical manifestations of dermatomyositis and systemic lupus erythematosus. However, these manifestations represent quite an unusual presentation of chronic cutaneous lupus erythematosus.The periorbital area is most frequently affected, while extensive facial involvement is much more unusual.A complete evaluation and cutaneous biopsy are essential to make the diagnosis and to rule out other disorders such as dermatomyositis, systemic lupus erythematosus and Morbihan disease.
慢性皮肤型红斑狼疮的表现多种多样。眶周和面部肿胀见于皮肌炎和系统性红斑狼疮，但作为单纯皮肤型狼疮的一种表现却鲜有报道。一名48岁女性有16年无症状的双侧面部肿胀和红斑病史，日晒后明显加重。无相关全身症状。全面评估未发现其他异常。皮肤活检显示红斑狼疮特征。她接受了光防护、外用他克莫司、羟氯喹和硫唑嘌呤治疗，有部分反应。面部肿胀伴红斑是慢性皮肤型红斑狼疮一种相当不常见的表现。皮肌炎、系统性红斑狼疮和莫尔比昂病是主要的鉴别诊断。
眶周和面部肿胀伴红斑是皮肌炎和系统性红斑狼疮的临床表现。然而，这些表现是慢性皮肤型红斑狼疮一种相当不常见的表现形式。眶周区域最常受累，而广泛面部受累则更为少见。全面评估和皮肤活检对于做出诊断以及排除其他疾病如皮肌炎、系统性红斑狼疮和莫尔比昂病至关重要。
