engleski

Subacute cutaneous lupus erythematosus : a case report

Subacute cutaneous lupus erythematosus (SCLE) has been identified as a photosensitive dermatosis with diffuse superficial cutaneous lesions evolving without atrophy or scarring. There is a strong association with anti-Ro/SS-A autoantibodies. Binding of these antibodies to nucleoprotein particles (Ro/SS-A), displaced from the nucleus by ultraviolet light (UV), occur on the surface of keratinocyte leading to apoptosis. We report a 52-year-old female patient with disseminated annular infiltrated erythematous plaques on the trunk, mostly on the skin of the back, which appeared after sun exposure and persists for months. Beside the clinical examination, diagnostic management included biopsy with histologic examination and direct immunofluorescence (DIF) of involved and uninvolved skin. Serologic testing for the presence of autoantibodies was performed by indirect immunofluorescence (IIF) on Hep-2 cell substrate (BioSystem S.A., Spain) for ANA-screening and ELISA confirmation test for ENA (Euroimmun, Germany). Direct immunofluorescence (DIF) of involved skin demonstrated granular IgM deposits at the dermal-epidermal junction while DIF of uninvolved sun-exposed skin did not revealed deposits. The histology showed typical findings for SCLE with vacuolar alteration of the basal cell layer and inflammatory cell infiltrate around vessels and appendiceal structures. Serologic testing revealed positive ANA with only equivocal anti-Ro/SS-A but significantly positive U1-RNP. Reported patient was otherwise asymptomatic woman with typical clinical and histologic findings of SCLE with strong photosensitivity reaction. Serologic abnormalities were also confirmed. Treatment with systemic antimalarial chlorocine and local application of a potent corticosteroid creme with avoidance of sun exposure revealed a good regression of skin lesions.

lupus erythematosus

nije evidentirano