Rheumatology, Rochester Regional Health, Rochester, New York, USA
Rheumatology, URMC, Rochester, New York, USA.
BMJ Case Rep. 2024 Jun 18;17(6):e258487. doi: 10.1136/bcr-2023-258487.
Hypertrophic discoid lupus erythematosus is a rare variant of chronic cutaneous lupus erythematosus and is often challenging to treat. A male in his early 60s presented with diffuse erythematous, crusty, pruritic plaques on his upper and lower extremities, face, upper back, dorsal aspect of the hands and chest. He also described prolonged morning stiffness, swelling of his fingers and wrists, oral sores and Raynaud's phenomenon. He was positive for antinuclear antibody and anti-SSA antibody and had low C3 and C4 proteins. The skin biopsy was consistent with hypertrophic discoid lupus erythematosus. He was diagnosed with systemic lupus erythematosus. Skin lesions were refractory to treatment with topical corticosteroids, topical acitretin, hydroxychloroquine, azathioprine or mycophenolate. Anifrolumab infusions were initiated with a near-complete resolution of cutaneous symptoms within 3 months.
肥厚性盘状红斑狼疮是慢性皮肤型红斑狼疮的一种罕见变异，治疗起来往往具有挑战性。一位 60 岁出头的男性患者上肢、下肢、面部、上背部、手部背侧和胸部出现弥漫性红斑、结痂、瘙痒斑块。他还描述了晨僵时间延长、手指和手腕肿胀、口腔溃疡和雷诺现象。他的抗核抗体和抗 SSA 抗体呈阳性，C3 和 C4 蛋白水平较低。皮肤活检结果符合肥厚性盘状红斑狼疮。他被诊断为系统性红斑狼疮。皮肤病变对局部皮质类固醇、局部阿维 A、羟氯喹、硫唑嘌呤或霉酚酸酯治疗反应不佳。阿尼鲁单抗治疗开始后，3 个月内皮肤症状几乎完全缓解。
