Nonbullous neutrophilic lupus erythematosus: A newly recognized variant of cutaneous lupus erythematosus

作者：Brinster Nooshin K^*; Nunley Julia; Pariser Robert; Horvath Brian

来源：Journal of the American Academy of Dermatology, 2012, 66(1): 92-97.

DOI：10.1016/j.jaad.2009.05.019

• direct immunofluorescence
• lupus erythematosus
• neutrophils
• panniculitis

Background: Neutrophils in the setting of systemic lupus erythematosus (SLE) are commonly associated with bullous disease. Rare cases of nonbullous neutrophilic lesions have been reported in patients with SLE. %26lt;br%26gt;Objective: This study used clinical and histologic findings of 4 patients to further define the newly emerging entity of nonbullous neutrophilic lupus erythematosus (LE). %26lt;br%26gt;Methods: We reviewed the clinical and pathological findings of 4 patients with known SLE who developed urticarial papules, plaques, subcutaneous nodules, or a combination of these. %26lt;br%26gt;Results: All patients were women with established SLE. Histopathological findings in all patients included an interstitial and perivascular neutrophilic infiltrate with leukocytoclasia, and variable vacuolar alteration along the dermoepidermal junction. Direct immunofluorescence study results in two patients were positive for C3, IgG, and IgM along the basement membrane zone. One patient also presented with neutrophil-rich lupus panniculitis. All clinical lesions resolved with immunomodulating/immunosuppressive agents. %26lt;br%26gt;Limitations: This study was limited by the small number of cases. %26lt;br%26gt;Conclusions: Nonbullous neutrophilic LE is an important entity to consider in the differential diagnosis of neutrophil-mediated eruptions. In addition, the histologic finding of neutrophils in the setting of lupus should alert one to the possibility of systemic disease. (J Am Acad Dermatol 2012;66:92-7.)

• 出版日期2012-1