1/24. Lupus erythematosus exacerbated by griseofulvin.Because griseofulvin is one of the safest systemic medications, its side effects are often forgotten. This paper serves as a reminder that griseofulvin can precipitate or exacerbate lupus erythematosus. Two patients are described: one had a photosensitivity reaction to griseofulvin which precipitated discoid LE skin lesions, without any previous evidence of LE. The other, who had known systemic LE, developed a systemic reaction, consisting of fever and malasise.- - - - - - - - - - ranking = 1keywords = lupus erythematosus, erythematosus, lupus (Clic here for more details about this article) |
2/24. Jessner's lymphocytic infiltrate and probable discoid lupus erythematosus occurring separately in two sisters.We describe two sisters with clinical and histological features suggestive of Jessner's lymphocytic infiltrate in one and discoid lupus erythematosus in the other. The occurrence of these two entities in one family now gives credence to the theory that Jessner's lymphocytic infiltrate is in the same disease spectrum as lupus and probably also polymorphic light eruption.- - - - - - - - - - ranking = 2.2806192421062keywords = lupus erythematosus, erythematosus, lupus (Clic here for more details about this article) |
3/24. Systemic lupus erythematosus and myoclonic epileptic manifestations.Systemic lupus erythematosus (SLE) frequently involves the central nervous system (CNS) and, in fact, epileptic manifestations may be one of the earliest symptoms of SLE. These early occurrences of epilepsy, however, can easily be misdiagnosed as indication of pure epileptic syndrome when the SLE diagnosis is still largely incomplete. We present a young girl who developed myoclonic photosensitive seizures at the onset of the illness, erroneously diagnosed as manifestation of a "pure" epileptic syndrome. Shortly after the onset of an anticonvulsant therapy (lamotrigine), there was a remarkable impairment of the general clinical condition: at that time a diagnosis of SLE was made and a specific treatment began. However, the seizures persisted and evolved toward status epilepticus which needed pentobarbitone therapy in an intensive care unit (ICU). After recovery, the girl gradually got better and during the 23 months of follow-up she received only corticosteroid therapy and did not experience seizures nor SLE relapses.- - - - - - - - - - ranking = 2.2593839727617keywords = lupus erythematosus, erythematosus, lupus (Clic here for more details about this article) |
4/24. A juvenile case of overlap syndrome of systemic lupus erythematosus and polymyositis, later accompanied by systemic sclerosis with the development of anti-Scl 70 and anti-Ku antibodies.We describe a 16-year-old girl with an overlap syndrome consisting of systemic lupus erythematosus (SLE) from the age of 7 and polymyositis (PM) from the age of 10, later accompanied by systemic sclerosis (SSc) from the age of 15. She was diagnosed as having SLE with exudative malar erythema, photosensitivity, and discoid rashes with positive antinuclear antibody (ANA) and anti-dna antibody titers. The diagnosis of PM was also made in accordance with findings of a high titer of muscle enzymes and a muscle biopsy specimen demonstrating marked degeneration of the muscle fibers and perivascular infiltration of mononuclear cells. She developed Raynaud's phenomenon and pitting ulcers on her fingers with positive anti-Scl 70 and anti-Ku antibodies, leading to a diagnosis of SSc. The patient was treated with prednisolone. To our knowledge this is the youngest case of SLE-PM overlap syndrome later accompanied by SSc.- - - - - - - - - - ranking = 2.3625994252648keywords = lupus erythematosus, erythematosus, lupus, systemic lupus erythematosus, systemic lupus (Clic here for more details about this article) |
5/24. Photopatch testing in seven cases of photosensitive drug eruptions.OBJECTIVE: The most important goal in the management of photosensitive drug eruptions, as in other types of drug eruptions is identification of the causative drugs to prevent reexposure to them. CASE SUMMARIES: Seven patients whose lesions were mainly distributed on sun-exposed areas underwent laboratory tests, phototests, and photopatch tests with suspected drugs. Phototests were done with ultraviolet A (UVA), UVB, and visible light. Drugs used in the photopatch tests were usually prepared as 10% concentrations in petroleum base, which did not produce reactions in 10 control subjects, followed by irradiation of suberythema doses of UVA. Systemic provocation by oral administration of small doses of causative drugs with irradiation of suberythema doses of UVA was performed to confirm the results of skin tests in four patients. Two patients were not rechallenged with the causative drugs. None of the patients had systemic lupus erythematosus, porphyria, or pellagra. All showed positive reactions to photopatch testing. Systemic provocation confirmed the results of photopatch tests in four patients. The two patients who were not rechallenged had no recurrence of lesions. One patient ingested only one drug at the time of eruptions, and provocation or avoidance was not attempted. A photoallergic mechanism was considered in five cases. CONCLUSIONS: Although there is no information about the appropriate concentrations or vehicles for suspected drugs, photopatch testing could be reliable for identification of causes of photosensitive drug eruptions. Besides piroxicam (a well-known photosensitizer) and carbamazepine, isoniazid and triflusal were identified as the causes of the reactions.- - - - - - - - - - ranking = 0.47251988505296keywords = lupus erythematosus, erythematosus, lupus, systemic lupus erythematosus, systemic lupus (Clic here for more details about this article) |
6/24. osteoporosis with underlying connective tissue disease: an unusual case.A 44-year-old male was initially seen by dermatologists, who noted an erythematous rash on sun-exposed areas, the back, shoulders, and upper arms. There was associated muscle weakness and significant weight loss. Investigation revealed mildly raised aspartate and alanine transaminases but normal creatine kinase. Inflammatory indices and antinuclear antibodies (ANAs) were normal. biopsy of the rash was reported as consistent with either dermatomyositis (DM) or acute lupus erythematosus. A diagnosis of DM was made, and prednisolone was given with improvement of the rash but deteriorating myopathy. The patient was referred to the rheumatology department, and further history revealed multiple vertebral fractures after falling from standing height; these had occurred six months prior to starting steroids. Besides smoking he had no other risk factors for osteoporosis. Examination showed normal muscle strength, no muscle tenderness, and no joint abnormality. Repeat muscle enzymes were normal, and ANAs were now 1 : 100, but dsDNA antibodies and extractable nuclear antigens were normal. Investigations for osteoporosis revealed a hypergonadotrophic hypogonadism picture. Further examination indicated scanty pubic and auxiliary hair, small testicles, and mild gynecomastia. He is married, though has no children of his own. The hormonal profile raised the possibility of Klinefelter's syndrome, which was subsequently confirmed with karyotyping of 47 XXY. hypogonadism has been established as a cause of osteoporosis in males, and in this case would explain the occurrence of fractures in the absence of other major risk factors. Systemic lupus erythematosus has been recognized in association with Klinefelter's syndrome; in view of the normal muscle enzymes, his rash is most likely due to acute discoid lupus with androgen deficiency causing muscle weakness.- - - - - - - - - - ranking = 0.92498885844914keywords = lupus erythematosus, erythematosus, lupus (Clic here for more details about this article) |
7/24. Hereditary C2 deficiency: association with skin lesions resembling the discoid lesion of systemic lupus erythematosus.Two patients with hereditary homozygous C2 deficiency are described. They showed many similar clinical features. Both had discoid-like skin rashes and serologic abnormalities consistent with SLE, but neither had evidence of involvement of any organ other than skin. Although biopsy of these lesions revealed expected changes by light microscopy, typical immunofluorescent findings were not present. The presence of the HL-A haplotype 10, W18 was seen in both families and was associated with the C2 deficiency gene. The 2 patients were mutually nonreactive in MLC tests and both were found to be homozygous for the LD7a type.- - - - - - - - - - ranking = 1.8900795402119keywords = lupus erythematosus, erythematosus, lupus, systemic lupus erythematosus, systemic lupus (Clic here for more details about this article) |
8/24. Bullous subacute cutaneous lupus erythematosus.We describe a 59-year-old woman, with a history of autoimmune disease and disseminated uterine leiomyosarcoma, who developed a photoaggravated, blistering skin eruption. An initial rash, at the outset of treatment with chemo- and radiotherapy, resembled erythema multiforme. review of the original skin biopsy showed it to be subacute cutaneous lupus erythematosus. There were no systemic symptoms or signs to suggest systemic lupus erythematosus. The much later photoaggravated rash consisted mainly of bullae and eventual epidermal denuding which resembled toxic epidermal necrolysis. We propose that the clinical and histological diagnosis is one of bullous subacute cutaneous lupus erythematosus in a patient with no other features of systemic lupus erythematosus.- - - - - - - - - - ranking = 3.65630053742keywords = lupus erythematosus, erythematosus, lupus, systemic lupus erythematosus, systemic lupus (Clic here for more details about this article) |
9/24. Lupus-like phototriggering in a young woman with benign summer light eruption.We report the case of a young woman with a single history of benign summer light eruption (BSLE) who developed delayed onset annular lupus-like lesions triggered by a polychromatic phototest, 6 weeks after the irradiation. BSLE of French authors is an idiopathic photodermatosis that corresponds to the minor form of polymorphic light eruption (PLE) of Anglo-Saxon authors. This patient may develop a true lupus erythematosus in the future as indicated by this lupus-like phototriggering and in view of the high prevalence of PLE in lupus patients.- - - - - - - - - - ranking = 0.51558260258569keywords = lupus erythematosus, erythematosus, lupus (Clic here for more details about this article) |
10/24. Treatment of refractory subacute cutaneous lupus erythematosus with efalizumab.We report the case of a 47-year-old woman who first presented with erythematous plaques on the upper portion of her right arm, which developed into an annular eruption involving the face, upper portion of the trunk, and limbs in a predominantly photosensitive distribution. Findings from histopathologic evaluation of a lesion from her arm were consistent with the clinical diagnosis of SCLE. After years of unsuccessful treatment with conventional medications for SCLE, she began therapy with efalizumab and experienced dramatic improvement in her cutaneous lesions after 6 weeks.- - - - - - - - - - ranking = 1.8075071782094keywords = lupus erythematosus, erythematosus, lupus (Clic here for more details about this article) |
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