Lupus erythematosus panniculitis in a 77-year-old woman
DOI:
https://doi.org/10.25251/r3kc1726Keywords:
cutaneous lupus, lupus erythematosus profundus, lupus panniculitisAbstract
Lupus erythematosus panniculitis (LEP) is an uncommon variant of lupus erythematosus, characterized by subcutaneous indurated nodules or plaques that often heal with lipoatrophy or scarring. We report a 77-year-old woman who presented with a 4-month history of painful subcutaneous nodules and erythematous plaques. She had a history of discoid lupus erythematosus in her 30s, which was successfully managed with topical treatments and had since resolved. Deep incisional biopsy of a plaque on her back confirmed the diagnosis of LEP. The patient improved with treatment including methotrexate, folic acid, and prednisone. This case highlights a unique clinical presentation of LEP, both in terms of patient age and lesion distribution, and underscores the critical role of histopathology in excluding subcutaneous panniculitis–like T-cell lymphoma.
References
1. Callen JP, Requena L. Cutaneous vasculitis and panniculitis. Rheumatology. 2015;6th ed:1344-1353. [PMID: 26141444]
2. Rangel LK, Villa-Ruiz C, Lo K, et al. Clinical characteristics of lupus erythematosus panniculitis/profundus: A retrospective review of 61 patients. JAMA Dermatol. 2020;156(11):1264-1266. [PMID: 32615572].
3. Arai S, Katsuoka K. Clinical entity of lupus erythematosus panniculitis/lupus erythematosus profundus. Autoimmun Rev. 2009;8(6):449-452. [PMID: 19110040].
4. LeBlanc RE, Tavallaee M, Kim YH, Kim J. Useful parameters for distinguishing subcutaneous panniculitis-like T-cell lymphoma from lupus erythematosus panniculitis. Am J Surg Pathol. 2016;40(6):745-754. [PMID: 27194732]
5. Braunstein I, Werth VP. Update on management of connective tissue panniculitides. Dermatol Ther. 2012;25(2):173-182. [PMID: 22741936].
6. Arps DP, Patel RM. Lupus profundus (panniculitis): A potential mimic of subcutaneous panniculitis-like T-cell lymphoma. Arch Pathol Lab Med. 2013;137(9):1211-1215. [PMID: 24044829].
7. Zheng Z, Teng J, Zeng M, Lu C. Clinical analysis of 10 cases with subcutaneous panniculitis-like T-cell lymphoma and tissue AURKA expression. Skin Res Technol. 2024;30(8):e13899. [PMID: 39112439].
8. Willemze R, Jansen PM, Cerroni L, et al. Subcutaneous panniculitis-like T-cell lymphoma: definition, classification, and prognostic factors: an EORTC Cutaneous Lymphoma Group Study of 83 cases. Blood. 2008;111(2):838-845. [PMID: 17934071].
9. Tomasini D, Berti E. Subcutaneous panniculitis-like T-cell lymphoma. G Ital Dermatol Venereol. 2013;148(4):395-411. PMID: 23900161.
10. Fraga J, García-Díez A. Lupus erythematosus panniculitis. Dermatol Clin. 2008;26(4):453-63. [PMID: 18793977].
11. Ou W, Zhao Y, Wei A, et al. Subcutaneous panniculitis-like T-cell lymphoma associated with hemophagocytic lymphohistiocytosis: a systematic review of 63 patients reported in the literature. Clin Exp Med. 2023;23(8):4575-4583. [PMID: 37840116].
12. Alsomali DY, Bakshi N, Kharfan-Dabaja M, El Fakih R, Aljurf M. Diagnosis and Treatment of Subcutaneous Panniculitis-like T-cell Lymphoma: A Systematic Literature Review. Hematol Oncol Stem Cell Ther. 2023;16(2):110-116. [PMID: 34015273].
13. Lemasson J, Frumholtz L, Jachiet M, et al. Male sex, discoid lupus erythematosus, and lower limb involvement are associated with systemic lupus in lupus panniculitis patients: A multicenter case series of 74 patients. J Am Acad Dermatol. 2022;87(1):219-221. [PMID: 34352346].
14. Lin EC, Liao JB, Fang YH, Hong CH. The pathophysiology and current treatments for the subcutaneous panniculitis-like T cell lymphoma: An updated review. Asia Pac J Clin Oncol. 2023;19(1):27-34. [PMID: 35509196].
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Copyright (c) 2026 Allison Bai, Erika Elliott, Gabriela Cobos (Author)
This work is licensed under a Creative Commons Attribution 4.0 International License.
