Coexistence of Late-Onset Systemic Lupus Erythematosus With Focal Segmental Glomerulosclerosis and Lichen Planus: A Case Report

Abstract

Late-onset systemic lupus erythematosus (LO-SLE) is defined when SLE develops after the age of 50 years and occurs in 3 to 18% of SLE patients. This late onset age has a strong modifying effect on the clinical presentation, disease course, response to treatment, and prognosis of SLE. LO-SLE often has delayed diagnosis and less common occurrence of severe manifestations. Arnaud et al. 1 suggests that pulmonary involvement and serositis are more frequent in LO-SLE, whereas malar rash, photosensitivity, arthritis, and nephropathy occur less commonly.In this article, we report a male patient presenting with lichen planus (LP) and focal segmental glomerulosclerosis (FSGS) who was subsequently diagnosed with LO-SLE. Our literature scan did not reveal any report on FSGS and LP as an initial manifestation in LO-SLE. CASE REPORTA 57-year-old male patient presented with complaints of pain in both hands and skin lesions in the left ankle for the last one year (Figure 1). He described symmetric joint pain and morning stiffness for longer than one hour. He had a two-year history of arthralgia and of using topical steroid and nonsteroidal anti-inflammatory drugs. He did not have any history of cutaneous lesions, oral or nasal ulcers, alopecia, pleural effusion, neuropathy, psychosis, seizures or myelitis. He did not have previous laboratory analyses. He had no history of smoking or alcohol consumption, or hypertension. His general condition was moderate, oriented, and cooperated. His blood pressure was 160/80 mmHg, and heart rate and temperature were normal. Locomotor system ABSTRACT Lichen planus and lupus nephritis with late-onset systemic lupus erythematosus (LO-SLE) may occur concomitantly. However, coexistence of LO-SLE with focal segmental glomerulosclerosis and lichen planus has not been defined. In this article, we report a 57-year-old male patient presenting with lichen planus and focal segmental glomerulosclerosis who was subsequently diagnosed with LO-SLE. To the best of our knowledge, this is the first case of LO-SLE presenting with lichen planus and focal segmental glomerulosclerosis.

Management of Lichen Planus in a Post Liver Transplant Patient with Lupus Erythematosus, and Ulcerative Colitis; A Case Report

“…In a case study with simultaneous vitiligo and LP, triamcinolone acetonide (0.1%) was administered topically 3 -4 times daily for two weeks, half an hour after meals, for the treatment of OLP lesions. Sargin and Gurer prescribed methylprednisolone (1 mg/kg body weight) and mycophenolate mofetil (1000 mg) for the simultaneous treatment of LP and SLE lesions (14). It should be noted that LE/LP synchronicity is a heterogeneous disease exhibiting the characteristics of both diseases.…”