|Year : 1991 | Volume
| Issue : 3 | Page : 146-147
PT Thankappan, G Sulochana
P T Thankappan
Source of Support: None, Conflict of Interest: None
A 35-years-old man presented with the classical features of relapsing polychondritis, namely bilateral auricular chondritis, iridocyclitis, episcleritis, rhintis and polyarthralgia with typical histological features. Patient was treated with dapsone without any benefit and short course of steroids caused regression of the condition.
Keywords: Relapsing polychondritis.
|How to cite this article:|
Thankappan P T, Sulochana G. Relapsing polychondritis. Indian J Dermatol Venereol Leprol 1991;57:146-7
Relapsing polychondritis (RP) is a fairly rare disorder where the manifestations are often widespread and are clinically and pathologically impressive or even dramatic. It usually affects middle aged men and are manifested by bilateral auricular chondritis, non-invasive seronegative polyarthritis, nasal, chondritis, ocular inflammation, respiratory chondritis and audio-vestibular damage. We are presenting a case of relapsing poly chondritis being a rare dermatologic problem.
| Case report|| |
A 35-year-old male clerk presented with multiple erythematous, slowly progressive tender nodules and plaques over the both pinnas of his ears of 3 months duration. Lobules of the ear were completely spared. Since last 6 months he had recurrent attacks of rhinitis and arthritis of larger joints. He had an iridocyclitis of the left eye one year back which was treated with steroids, by an Ophthalmologist. Episcleritis of the left eye was present. No systemic abnormality was detected during physical examination.
Laboratory investigations revealed a persistently raised ESR, and VDRL, Rose water test, L. E. Cells test were negative. Skin clipping and scrapings for AFB was negative. Skin biopsy showed an apparently normal epidermis and upper dermis. The cartilage cells appeared degenerated with vacuolization,
nuclear pyknosis and loss of basophilia. A dense inflammatory infiltrate consisting of neutrophils, lymphocytes, plasma cells and macrophages were seen among the degenerated cartilage cells.
Classical clinical features namely auricular chondritis, rhinitis, ocular inflammation with typical histopathology, a diagnosis of relapsing polychondritis was made and the patient was treated with prednisolone 30 mg daily and was tapered and stopped within a period of 4 months. The lesions improved dramatically with steroids.
| Comments|| |
Relapsing polychondritis is a rare disorder and it's presentation to a dermatologist is still rare. To the best of our knowledge this case is the first to be reported in the dermatologic literature in India. Though dapsone was reported to be effective in relapsing polychondritis. our case did not respond to dapsone. Katz also experienced similar results with dapsone.
| References|| |
|1.||Pearson CM : Relapsing polychondritis, in Arthritis and allied conditions, 9 th edition, Editors McCarthy DJ, Lea & Febiger, Philadelphia, 1979; 188-90. |
|2.||West PDB : Relapsing polychondritis, an unusual presentation, J Laryngol Ottol, 1988; 102 : 254255. |
|3.||Barranco P et al : Treatment of Relapsing polychondritis with depsone, Arch Dermatol,1976; 112 : 1286. |
|4.||Martin J et al Relapsing polychondritis treated with dapsone, Arch Dermatol,1976; 112 : 1272, 74. |
|5.||Katy SI : Relapsing Polychondritis, in Dermatology in General Medicine, third edition, edited by Fitzpatrick TB, Eisen AZ, Wolff K et al, McGrawHill Book Company. New York, 1987; 1852-54. |
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