Erythema multiforme-like eruption in subacute cutaneous lupus erythematosus

Erythema multiforme-like eruption in subacute cutaneous lupus erythematosus

s204 Posters - Auroiuutuute only observed a slight increase of liver enzymes and decrease of lymphocytes and their subsets. MMF is a new immuno-supp...

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s204

Posters - Auroiuutuute

only observed a slight increase of liver enzymes and decrease of lymphocytes and their subsets. MMF is a new immuno-suppressive drug that selectively inhibits de novo purine synthesis. Since T and B cells depend on this pathway MMF specifically inhibits their proliferation. Preliminary reports in rheumatoid arthritis and SLE suggest that it may be beneficial in the treament of autoimmune disease. Here we present evidence that it is a promising agent in therapy-refractory cutaneous LE, which remains to be proven in prospective, controlled clinical trials. I P75 Erythema multiforme-like eruption in

subacute cutaneous lupus erythematosus

P. Vereecken, S. Tas, D. Parent, C. De Dobbeleer, M. Heenen. Dept of Dermatology, Erasme Hospiral, Brussels, Belgium Subacute Cutaneous Lupus Erythematosus (SCLE) is considered as a distinct subset of Lupus Erythematosus (LE) because of characteristic clinical, histological and immunological features. Clinical findings include non-scarring papulo-squamous, annular or vesicular lesions. Infrequently, SCLE may mimic initially an Erythema Multiforme (EM). We report the case of a 49-year-old man presenting with a subacute widespread eruption of cutaneous target lesions. The patient had no medical past and did not take any medication. Physical examination revealed pm-pun of palms and soles, and acrocyanosis. No mucous lesions could be observed. Laboratory tests disclosed speckled antinuclear antibodies titer of l/10000, double-stranded anti-DNA, anti-SSA, anti-RNP and anti-SM antibodies. Rheumatoid factor and anti-SSB antibodies were not detected. Histological examination of affected skin showed vacuolar alteration at the dermo-epidermal junction, dermal oedema and superficial lymphohistiocytic infiltrate. Immunofluorescence examination was negative in unaffected skin. According to these clues, the diagnosis of SCLE was established. Complete clearing of skin lesions was achieved with hydroxychloroquine sulfate. EM-like eruption associated with SCLE has to be differentiated from Rowell’s syndrome, an EM-like eruption occurring acutely in patients with systemic LE and discoid LE in the presence of anti-SSB antibodies and a positive rheumatoid factor. I P76 Subacute cutaneous lupus erythematosus:

A case with atypical arcuate lesions

E. Jugovl, H. JedliEkovB, V. Semradovfi. 3. Auna Llniversity Hospital,

Bmo,

Czech

Republic

Subacute cutaneous lupus erythematosus (SCLE) is characterised by annular and /or papulosquamous skin lesions, photosensitivity, mild systemic disease and anti Ro/SS A antibodies. Our patient was a 22-year-old generally healthy woman, her only complaint was frequent cephalea. She was referred to our department with symmetric arcuate infiltrated lesions on her cheeks, which had developed 4 months earlier after a sun exposure. Histological examination had been inconclusive and local corticosteroid therapy had been without effect. Repeated histology and direct immunofluorescence showed features of lupus erythematosus. Laboratory tests revealed positive anti RolSS A, anti Ro/SS B and anticardiolipin antibodies and rheumatoid

diseases

factor. Neurologic examination was normal. The diagnosis of SCLE was made and therapy with hydroxychloroquine was started. The lesions healed without atrophy or scarring within 6 weeks. I P77 Juvenile discoid lupus erithematosus F. Sim6n, M. Alcalde, J.F. Moriana. Torrecdrdeuas Hospiral, Altueria,

Spain

Discoid Lupus Erythematosus (DLE) is a skin disease characterized by the presence of well-defined, raised, erithematous lesions that spread slowly with an irregular outline, while the centers heal with scaling, atrophy and scarring. The lesions are located most often on the face, ears and scalp. DLE is rare in infants. We report a 6 years old boy, with a history of crusted discrete lesions on the cheeks and ears. No photoaggravation was present. Skin biopsies and full serological investigations confirmed the diagnosis. A differential diagnosis of DLE, hydroa vacciniforme or erythropoietic protoporphyria is proposed. I P76 Pronostic factors in cutaneous necrotizing

vasculitis

J.M. Carrascosa, I. Bielsa, M. Esquius, M. Ribera, C. Ferrfindiz. Hospital Universirari Germans Trias i Pujol, Badalona,

Spain

The prognosis of cutaneous necrotizing vasculitis (CNV), defined by visceral involvement and course of the disease, may be difficult to establish when considering only the presenting features. Objective: The aim of the study was to determine the clinical and laboratory parameters and correlate these findings with visceral involvement or a chronic or recurrent course of the disease. Material and Methods: Thirty-seven patients were included (male 22; female 14). All CNV patients were diagnosed by clinic-pathologic criteria. Follow up was 6-months at least. Results: The finding of immunologic abnormalities was statistically related to a chronic or a recurrent course of CNV (p = 0.014). On the other hand, gastrointestinal involvement was identified as a statistically significant clinical marker for renal involvement (p = 0.011). The presence of cutaneous ulcers or hemorragic bullae was related to previous drug intake or renal and neural involvement. Conclusions: Gastrointestinal involvement and immunological abnormalities have a prognostic value in CNV.

(p791 Vasculitis allergica in clinical, morphological and immunological aspects J. Roszkiewicz, M. Czubek, M. Sztaba-Kania. Medical University of Gdajfsk, Poland 68 patients with vasculitis allergica (VA) were examined. In 51 cases the clinical picture confirmed purpura hyperergica, while in I7 cutaneous manifestations were not haemorrhagic in character and suggest other dermatoses: morbus Duhring, erythema elevatum et diutinum, erythema multiforme, erythema inddra-