LUPUS ERYTHEMATOSUS PROFUNDUS

By Gary M. White, MD

lupus profundus


Also known as lupus panniculitis, lupus erythematosus profundus is an unusual variant of cutaneous lupus erythematosus that is characterized by chronic, recurrent inflammation of the underlying fat leading to nodules, lipoatrophy and significant depression.

Clinical

Lipoatrophy, deep subcutaneous nodules, and/or morphea-like lesions may occur most commonly on the upper arm, breasts, thighs, buttocks, and face. The overlying skin may be normal or show DLE lesions.

Workup

The usual workup and labs for lupus should be performed.

Treatment

Hydroxychloroquine 200 QD-BID is usually given until control is achieved and then the dose tapered over months as able. Disease-free periods may occur with occasional relapses. Rituximab has been used successfully [Dermatol Therapy 2013:26;415-8]. Prednisone and dapsone have been used. For related therapy, see cutaneous lupus erythematosus.

Additional Pictures

lupus erythematosus profundus lupus profundus

Note the atrophic lesion in the upper left as well.
lupus profundus

Typical location on the upper outer arm.
lupus erythematosus profundus

Deep-seated nodules on the upper outer arm.
lupus erythematosus profundus

Livedo erythema and ulceration.
lupus erythematosus profundus

Punched out ulcer.
lupus erythematosus profundus

References

Indian J Dermatol Venereol Leprol 2014;80:275-7

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