Henehan Mason R, Stillman Sydney, Grubbs Hailey E, Cohen Carlos
Dermatology, Broward Health Medical Center, Fort Lauderdale, USA.
Internal Medicine, Yale University/Waterbury Hospital, Waterbury, USA.
Cureus. 2023 Mar 31;15(3):e36956. doi: 10.7759/cureus.36956. eCollection 2023 Mar.
Tumid lupus erythematosus (TLE), a subtype of chronic cutaneous lupus erythematosus (CCLE), presents with firm erythematous plaques that lack surface changes such as follicular plugging or scale. These lesions most commonly occur on the face and other photosensitive areas but may also present on the scalp as recurrent circumscribed patches of non-cicatricial alopecia. Including TLE as part of the differential for non-cicatricial alopecia can prove helpful in patients who fail to improve with empiric first-line treatments for more common causes of hair loss. We report a case of TLE that clinically mimicked alopecia areata and seek to highlight the relevant clinical and histological features to promote earlier diagnosis of this entity. A discussion of improved diagnostic and treatment modalities, as well as identifying the uncommon but possible association of TLE with underlying systemic disease, adds to the importance of maintaining clinical suspicion for TLE. Finally, we provide an overview to discriminate TLE from other forms of cutaneous lupus and their unique patterns of alopecia when presenting on the scalp.
肿胀性红斑狼疮（TLE）是慢性皮肤型红斑狼疮（CCLE）的一种亚型，表现为坚实的红斑性斑块，缺乏如毛囊堵塞或鳞屑等表面变化。这些皮损最常发生于面部和其他光敏部位，但也可能出现在头皮，表现为反复发作的局限性非瘢痕性脱发斑。对于非瘢痕性脱发患者，若经验性一线治疗未能改善由更常见脱发原因导致的脱发情况，将TLE纳入鉴别诊断可能会有所帮助。我们报告一例临床上酷似斑秃的TLE病例，并试图强调相关的临床和组织学特征，以促进对该疾病的早期诊断。对改进的诊断和治疗方式的讨论，以及识别TLE与潜在系统性疾病不常见但可能存在的关联，进一步凸显了对TLE保持临床怀疑的重要性。最后，我们提供了一个概述，以区分TLE与其他形式的皮肤型狼疮，以及它们在头皮出现时独特的脱发模式。
