[Lupus erythematosus profundus: two cases with ultrastructural study].

Lupus erythematosus profundus (panniculitis) is an unusual clinical variant of lupus erythematosus in which the lesions occur in deeper corium and panniculus. The diagnosis usually causes difficulty. Both reported cases are similar and concern young men with subcutaneous nodules appearing on the face and leaving depressed areas. Histological examination reveals a marked infiltrate in the dermis especially around the skin appendages, reaching the deep dermis and the fat tissue; this infiltarte is composed mainly of lymphocytes and histiocytes. Some moderate epidermal changes are present: liquefaction degeneration of the basal cell layer, epidermal atrophy, thickening of basement membrane (P. A. S.). Direct immunofluorescence of the lesions showed, in one case IgG deposits at the dermo-epidermal junction. Ultrastructural findingd are similar in both cases and may be an important point of diagnosis for isolated forms: -- tubular structures "paramyxo-virus-like-inclusions" are present in dermal infiltrate, endothelial cells and sometimes in keratinocytes of the basal layer; -- the basal lamina has many folds and villous projections;-- vacuoles and concentric lamellar formations are observed inside keratinocytes. No clinical or immunological signs of systemic lupus were found. Antimalaric drugs clear up the nodules.