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LETTER TO EDITOR
Year : 1995  |  Volume : 61  |  Issue : 4  |  Page : 241-242

Sub-acute cutaneous lupus erythematosus




Correspondence Address:
B Sengupta


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Source of Support: None, Conflict of Interest: None


PMID: 20952975

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How to cite this article:
Sengupta B, Sarkar J N, Bhattacharya P, Barman, MK. Sub-acute cutaneous lupus erythematosus. Indian J Dermatol Venereol Leprol 1995;61:241-2

How to cite this URL:
Sengupta B, Sarkar J N, Bhattacharya P, Barman, MK. Sub-acute cutaneous lupus erythematosus. Indian J Dermatol Venereol Leprol [serial online] 1995 [cited 2019 Dec 7];61:241-2. Available from: http://www.ijdvl.com/text.asp?1995/61/4/241/4228



  To the Editor, Top


Sub-acute cutaneous lupus erythematosus (SCLE) constitutes about 10-15% of total lupus erythematosus (LE) cases.[1],[2] A 62-year-old housewife presented with widespread psoriasiform lesions of 7 days duration which appeared on back of shoulders, extensor surfaces of the arms, back above the waistline, V area of the upper chest and on extensor surfaces of legs in chronological order. The early lesions were slightly scaly erythematous papules. In the loin the lesions coalesced to form psoriasiform plaque. She had palatal ulcer and some degree of nonscarring frontal alopecia. The patient had suffered from fever (99-100 F) and pain in shoulders and neck for the last 5 months. Nails revealed no abnormality, past history revealed that the patient was admitted in BS Medical College & Hospital, Bankura for sulphonamide-induced Stevens - Johnson syndrome (SJS). At that time patient was treated with steroids, associated IHD with CCF was also diagnosed and managed with digoxin and dytide (thiazide) drug for one week.

Routine laboratory investigations showed - Hb 4.8gm%; TLC 10,000/cumm; DLC N 45%, L 40%, E 15%; ESR - 75mm in 1st hour; platelet count 2,60,000/cumm; LE cell (-)ve; ANF (+)ve; VDRL (-)ve; Urine : epithelial Cells - a few, pus cell 3-5/HPF, RBC nil, cast nil; chest X-ray slightly enlarged cardiac shadow in transverse diameter with ventricular predominance but no lung parenchymal or hilar abnormality; ECG - IHD with left ventricular strain pattern. Skin biopsy from the representative lesion was compatible with SCLE. The patient was put on low dose prednisolone (30mg/day) and chloroquine phosphate (500mg/day). After 2 weeks of therapy she responded well.

The patients of SCLE are usually young and middle aged white women of 15 to 40 years.[3] It is very uncommon in blacks of either sex. The cutaneous lesions of SCLE are differentiated from the generalised DLE on clinical grounds alone.[1] In contrast with marked systemic illness in systemic LE, SCLE patients frequently have mild systemic illness and no serious CNS, renal or systemic vascular involvement; yet half of the patients fulfill the ARA criteria for SLE.[2] Thin, easily detachable scales, psoriasiform lesions in striking distribution pattern with positive ANF, anaemia, raised ESR, musculoskeletal complaints, fever and compatible skin biopsy report helped in the diagnosis.

However, in this case it is yet to be established whether such a short term therapy with sulfonamide or thiazide could be a precipitating factor of SCLE.

 
  References Top

1.Richard D, Santheimer, Rothfield N, Cilliam JN. Cutaneous manifestations of diseases in other organ systems. In : Dermatology in General Medicine (Fitzpatrick TB, Eisen AZ, Wolff K, et al, eds). 3rd edn. Vol 2. New York : McGraw - Hill Book Company, 1987;1816-946.  Back to cited text no. 1    
2.Rowell NR. The collagen or connective tissue diseases. In : Textbook of Dermatology (Rook A, Wilkinson DS, Ebling FJG, Champion RH, Burton JL, eds). 4th edn. Vol 2. Oxford : Blackwell Scientific Publicaitons, 1986;1281-392.  Back to cited text no. 2    
3.Arnold HL, Odom RB, James WD. Connective tissue diseases. In : Andrews' Diseases of the Skin - Clinical Dermatology (Arnold HL, Odom RB, James WD, eds). 8th edn. Philadelphia : WB Saunders Company, 1990;159-85.  Back to cited text no. 3    




 

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