Lupus Erythematosus Tumidus:Clinicopathological Study Of 29 Cases

Objective: This study is aimed to find some evidence for early diagnosis of lupus erythematosus tumidus(LET).Materials and Methods: We reviewed the data of patients with LE between 2012 and2017 in our department.Finally,29 cases were diagnosed as LET.The clinical features,workups,treatment and responses were analyzed.Results: Ratio of male(10)to female(19)patients was 1:1.9.The mean age was 45 ±12.8 years(range,19~75 years).The median time between onset of disease and diagnosis was 4.5 months(range,3 days to 10 years).The lesions located on the face in 18 patients,and on the face as well as trunk or arms in 10 patients,on the arms in 1 patient.All of them,19 patients presented with multiple lesions.Only 11 patients had mild itching or mild tenderness.Thirteen patients experienced with arthralgia,dry mouth or hair loss.Six patients reported photosensitivity,15 patients had no photosensitivity and 8 patients were not sure.Among the 26 patients examined for autoantibodies,ANA was positive in 18 patients,and SSA and/or SSB positive in 10 patients.Complements,other autoantibodies,biochemistry tests were normal.Histopathologically,all the 29 patients showed peri-adnexal and perivascular infiltrate of lymphocytes.Alcian staining showed mucin accumulation in the spaces in 9 patients between the collagens.Sixteen patients were administered with hydroxychloroquine(HCQ)300~400 mg/d,as monotherapy in 8patients and combination with thalidomide and/or oral steroid in 8 patients.No patients developed involvement of other organs and systems during the follow-up.Conclusions: Sun-exposure areas such as face are LET predilection sites.LET occurs primarily in middle aged women.Most LET patients had a benign course.HCQ is the first choice of systemic treatment for LET by dermatologists.