Garcia Brianae, Hasnaoui Anis, Ramdass Prakash V A K
Department of Public Health and Preventive Medicine, St. George's University School of Medicine, St. George, Grenada.
Visceral and Digestive Surgery, Medical School of Tunis, Tunis El Manar University, Tunis, Tunisia.
Case Rep Dermatol. 2024 May 23;16(1):128-132. doi: 10.1159/000538737. eCollection 2024 Jan-Dec.
Lupus erythematosus tumidus (LET) is a rare photosensitive dermatosis that is categorized as intermittent cutaneous lupus erythematosus. It shares clinical similarities and histopathological features with other skin disorders, such as erythema nodosum, lymphocytic infiltrate of Jessner, and reticular erythematous mucinosis, thus making diagnosis quite challenging. We present a patient with LET whose diagnosis was confirmed after seeing several doctors.
A 52-year-old Hispanic female presented with tender erythematous nodules on her thighs for approximately 1 month. She was suspected of having erythema nodosum secondary to coccidioidomycosis and was prescribed fluconazole 200 mg for 30 days but showed no improvement. However, histopathological and direct immunofluorescence tests later confirmed a diagnosis of LET. The patient was treated with hydroxychloroquine, and the lesions improved remarkably after 2 weeks.
LET is a rare dermatosis that closely resembles other dermatologic conditions such as erythema nodosum, lymphocytic infiltrate of Jessner, and reticular erythematous mucinosis. Diagnosis based on clinical features alone should be avoided, and ideally, treatment should only be initiated after confirmatory histopathological testing.
肿胀性红斑狼疮（LET）是一种罕见的光敏性皮肤病，归类为间歇性皮肤型红斑狼疮。它与其他皮肤疾病，如结节性红斑、杰斯纳淋巴细胞浸润症和网状红斑性黏蛋白病，在临床和组织病理学特征上有相似之处，因此诊断颇具挑战性。我们报告一例LET患者，其诊断在看过几位医生后才得以确诊。
一名52岁的西班牙裔女性因大腿出现压痛性红斑结节约1个月前来就诊。她被怀疑患有球孢子菌病继发的结节性红斑，并被处方服用氟康唑200毫克，疗程30天，但未见改善。然而，组织病理学和直接免疫荧光检查后来确诊为LET。患者接受了羟氯喹治疗，2周后皮损明显改善。
LET是一种罕见的皮肤病，与结节性红斑、杰斯纳淋巴细胞浸润症和网状红斑性黏蛋白病等其他皮肤病密切相似。应避免仅基于临床特征进行诊断，理想情况下，应在组织病理学检查确诊后再开始治疗。
