Histopathologic findings in lupus erythematosus tumidus: Review of 80 patients

Kuhn, Annegret; Sonntag, Monika; Ruzicka, Thomas; Lehmann, Percy; Megahed, Mosaad

doi:10.1067/mjd.2003.435

Cited by 103 publications

(94 citation statements)

References 40 publications

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“…Whereas patients with active SLE have a reduced number of Treg in the circulation (14-17), we observed such a decrease in the number of Treg only at the site of inflammation in skin lesions of patients with CLE. This reduction in the number of Treg in the dermal infiltrate was independent of the CLE subtype, irrespective of the fact that SCLE and DLE show epidermal involvement (e.g., interface dermatitis), while LET primarily presents with a dermal lymphocytic infiltrate and interstitial mucin deposition (34). Interestingly, the number of Treg was not reduced in patients with other inflammatory skin diseases with pathologic features in the epidermis, such as atopic dermatitis, psoriasis, lichen planus, and eczema.…”

Section: Discussionmentioning

confidence: 82%

Low number of regulatory T cells in skin lesions of patients with cutaneous lupus erythematosus

Franz¹,

Fritzsching²,

Riehl³

et al. 2007

Arthritis & Rheumatism

123

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Objective. To define the phenotype and function of CD4؉,CD25؉ regulatory T cells (Treg) in patients with cutaneous lupus erythematosus (CLE), a heterogeneous autoimmune disease characterized primarily by inflammatory skin lesions.Methods. The number of Treg in skin specimens obtained from patients with various subtypes of CLE was investigated by immunohistochemical analysis, using anti-Foxp3 and anti-CD4 monoclonal antibodies. Furthermore, characterization of peripheral blood CD4؉,CD25؉ Treg from normal healthy donors and patients with CLE was carried out by flow cytometry, analyzing the expression of Foxp3 and Treg subpopulations. We also purified CD4؉,CD25 high Treg obtained from patients with CLE and tested the sensitivity of these cells to CD95L-mediated apoptosis.Results. Quantitative analysis of CD4؉ T cells in skin lesions from patients with CLE revealed that the number was similar to that in lesions from patients with other chronic inflammatory diseases, but the number of Foxp3؉ Treg in CLE was significantly reduced. There was no correlation between disease subtype and the frequency of Foxp3؉ Treg in the skin of patients with CLE. In peripheral blood, no significant differences were observed in the number and phenotype of CD4؉,CD25؉ Treg or in the sensitivity to apoptosis of CD4؉,CD25 high Treg derived from patients with CLE and those derived from normal healthy donors.Conclusion. These data suggest that an organspecific abnormality of Treg in the skin underscores the importance of analyzing Treg in the affected tissue. Such a local process might give insight into the pathogenic mechanisms of CLE and differs from a global peripheral dysfunction as reported for patients with a systemic manifestation of the disease.

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Section: Discussionmentioning

confidence: 82%

Low number of regulatory T cells in skin lesions of patients with cutaneous lupus erythematosus

Franz¹,

Fritzsching²,

Riehl³

et al. 2007

Arthritis & Rheumatism

123

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“…Only one study has described the relative proportions of the different components of CCLE in the population (2). The widely accepted and classic Gilliam classification for lupus erythematosus has been used in our study, because the Dusseldorf classification was not validated in 2000; the latter excludes lupus erythematosus tumidus from the CCLE entity (7,8). In our survey, classic DLE was the sole variant identified.…”

Section: Discussionmentioning

confidence: 97%

Incidence of chronic cutaneous lupus erythematosus in French Guiana: A retrospective population‐based study

Deligny¹,

Clyti²,

Sainte‐Marie³

et al. 2010

Arthritis Care & Research

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Objective. To retrospectively study the incidence of chronic cutaneous lupus erythematosus (CCLE) in French Guiana (FG), South America, during the period 1995-1999. Methods. Private and public physicians specializing in dermatology, rheumatology, and internal medicine were asked during the year 2000 about lupus cases. We reviewed hospitals' files in data-processing departments. Results. Twenty new cases of CCLE, mostly discoid form, were identified during this 5-year period in this population of predominantly African descent. The average annual incidence of the disease was 2.59 per 100,000 inhabitants (95% confidence interval 1.5-4). However, our methodology could introduce underestimation of the incidence of the disease. Conclusion. The average annual incidence of CCLE in FG appears to be low in this retrospective study, but is very similar to the only previously published data in the US.

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“…Histopathological examination is essential in the establishing diagnosis of LET. Characteristic features include a deep lymphocytic perivascular and a periadnexal infiltrate and the presence of mucin [15].The epidermis is always intact. LET is identified by the presence of ICAM-1 in the epidermis only ,in comparison to SLE where ICAM-1 expression is predominant throughout all layers of the skin [16].…”

Section: Discussionmentioning

confidence: 99%

Lupus Tumidus: underreported variant of lupus erythematosus (a case report and review of the literature)

Kazlouskaya¹,

Lal²,

Khaikova³

2014

Our Dermatol Online

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Introduction: Lupus erythematosus tumidus (LET) is an underreported variant of lupus erythematosus (LE) that is characterized by soft urticarial-like elements usually located on the sun exposed skin. LET is featured with high photosensitivity. Lesions of LET resolve without scarring and do not cause disfigurement as seen in the discoid LE variants. Lesions of LET may co-exist with other variants of LE: discoid or systemic.Main observations: The case presents a female patient with LET localized on the lateral infraorbital areas of her face and cheeks. Histopathological evaluation showed a lymphocytic infiltrate in the middle and deeper parts of the dermis. This article also presents a contemporary review of the clinical variants of LET, histopathological features and approaches to the treatment of LET. Conclusions: LET should be considered in urticarial-like lesions on the skin of the face and other skin exposed areas. Histopathological examination is needed to make a definitive diagnosis of the condition and helps in cases when the clinical presentation is subtle or nonspecific.

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Histopathologic findings in lupus erythematosus tumidus: Review of 80 patients

Cited by 103 publications

References 40 publications

Low number of regulatory T cells in skin lesions of patients with cutaneous lupus erythematosus

Low number of regulatory T cells in skin lesions of patients with cutaneous lupus erythematosus

Incidence of chronic cutaneous lupus erythematosus in French Guiana: A retrospective population‐based study

Lupus Tumidus: underreported variant of lupus erythematosus (a case report and review of the literature)

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