Histology of Lupus Erythematosus

Marked papillary dermal edema – an unreliable discriminator between polymorphous light eruption and lupus erythematosus or dermatomyositis

“…The edema had largely diminished with resolution of lesions 9 . In 1954, Ellis and Bundick reported significant papillary dermal edema in 22 of 25 (88%) cases of acute LE (now ACLE) and 42 of 163 (26%) cases of DLE, primarily in lesions of acute DLE 10 . One report from 1973 suggested that papillary dermal edema was invariably present in active lesions of DLE and SLE, whereas subsiding lesions typically did not display edema 12…”

“…Furthermore, most contemporary studies and textbooks do not list papillary dermal edema as a feature of LE 3,7,8 . However, many studies that defined the original microscopic features of LE explicitly included papillary dermal edema as a microscopic attribute observed in sections from patients with systemic LE (SLE) who had clinical lesions of acute cutaneous LE (ACLE), as well as in patients with early lesions of discoid LE (DLE) 9,10 …”

Assessment of the ‘no eosinophils' rule: are eosinophils truly absent in pityriasis lichenoides, connective tissue disease, and graft‐vs.‐host disease?

“…In a review of 15 case series describing the histopathologic features of LE and DM in over 500 patients published between 1931 and 2010, none state whether eosinophils are usually present or absent 14–28 . Rarely, however, in published discussions of the differential diagnosis of LE or DM, eosinophils are noted as being present in other disorders such as erythema multiforme (EM) 14,24 or ‘solar dermatitis', 29 implying that eosinophils are not typically present in LE or DM.…”

Lúpus eritematoso cutâneo: aspectos clínicos e laboratoriais

“…Histologically, discoid lesions present: 1) hyperkeratosis with follicular plugging; 2) thinning and flattening of the stratum Malpighi's, less intense than in forms of subacute lupus erythematosus; 12,13 3) hydropic degeneration of basal cells; 4) a predominantly lymphocytic infiltrate along the dermal-epidermal junction, around the fair follicles and eccrine ducts, in an interstitial pattern; 14 5) edema, vasodilatation and extravasation of red blood cells in the upper dermis. 6 PAS stain very often shows thickening of the basal membrane.…”