This 45-year-old woman presented with a three-month history of following lesions on the face and buttocks. Ten years previously , she had a similar episode that resolved spontaneously and resulted in atrophic, non-erythematous plaques on her upper legs. She denied arthralgia, arthropathy, myalgia, fatigue, fever, Raynaud’s phenomenon, gastrointestinal symptoms . What can be the most possible diagnosis?
T cell Lymphoma
- Lupus panniculitis, or lupus profundus, is a variant of lupus erythematosus that primarily affects subcutaneous fat.
- In nearly all cases there are deep, erythematous plaques and nodules, and some ulcers, which usually involve the proximal extremities, trunk, breasts, buttocks, and face.
- Lesions may be tender and painful and frequently heal with atrophy and scars.
- In 70 percent of patients with lupus panniculitis there will be either preceding, subsequent, or concomitant lesions of discoid lupus erythematosus.
- Further, lupus panniculitis occurs in two to five percent of patients with systemic lupus erythematosus .
- Most patients are adults between 20 and 60 years old, with a female to male ratio of approximately two to one.
- Lupus panniculitis is a chronic condition that often involves persistent lesions that subsequently heal with disfigurement.
- Lupus panniculitis often responds to treatment with antimalarials, such as hydroxychloroquine .
- Systemic glucocorticoids should be reserved for widespread and resistant lesions.