Clinical and Histopathologic Studies of Lupus Erythematosus Panniculitis in Korea

Kim, Young Gi; Yoon, Tae Young

Abstract

BACKGROUND
Lupus erythematosus panniculitis (LEP), (or lupus erythematosus profundus), is an unusual variant of lupus erythematosus which primarily affects subcutaneous fat. LEP may occur with or without other manifestations of cutaneous or systemic lupus erythematosus. Only a few studies on the clinical and histopathologic manifestation of LEP have been conducted in Korea. OBJECTIVE: The purpose of this study was to investigate clinical, laboratory, and histopathologic features of LEP in Korean patients. METHOD: A total of 30 patients confirmed as having LEP at the Chungbuk National University Hospital between 1 July 1994 and 31 June 2004 were included in this study. The medical records and histopathologic findings were reviewed. RESULTS AND CONCLUSION: 1. LEP occurred predominantly in females, with the female to male ratio being 4: 1. The mean age at diagnosis was 38.5 years. 2. The most common clinical features were nodules or plaques, and 60% of the patients had pain or tenderness. Skin lesions affected the proximal arm area, face, trunk, scalp, and buttocks. In 26% of cases, LEP was associated with discoid lupus erythematosus (DLE), and 13% had evidence of mild systemic lupus erythematosus (SLE). The antinuclear antibody (ANA) was positive in 30% of cases. 3. The main histopathologic characteristics of LEP were predominant lymphocytic lobular panniculitis, hyaline necrosis, mucin deposit, and lymphoid aggregates. 4. Treatments included antimalarial drugs, systemic corticosteroids, intralesional corticosteroids, or topical potent corticosteroids under occlusion. They produced some improvement in most cases, however LEP exhibited a chronic nature with a high relapse rate.