Lupus erythematosus profundus in black South Africans.
BACKGROUND
Lupus erythematosus profundus (lupus panniculitis) is a rare variant of lupus erythematosus with predominant involvement of the subcutaneous tissue. There are only a few reported series of patients with this condition; none in individuals of African ancestry. The aim of the study was to evaluate clinical, histopathological and laboratory findings in black South African patients with lupus profundus.


METHODS
Ten prospectively observed patients were studied. Skin biopsies were performed, and several laboratory tests routinely employed in patients with lupus erythematosus were carried out. All patients were followed up for at least a year and their response to treatment was assessed.


RESULTS
All patients were females. Mean age at diagnosis was 28.5 years. Face was the most common site of involvement. In five patients, the periorbital edema was the initial manifestation. Only one patient had systemic lupus, and three patients also showed lesions of discoid lupus. In only 30% of the patients were the ANA titers greater than 1 : 80, and positivity in other lupus tests was rare and inconsistent. In general, patients responded to antimalarials and/or systemic corticosteroids.


CONCLUSIONS
African patients with lupus profundus when compared with other series comprising Asian and white patients showed greater frequency of periorbital edema as the initial manifestation. Review of the literature disclosed that this subset of lupus profundus appears to have a more benign course.
Jacyk
W K
WK
Department of Dermatology, University of Pretoria, Pretoria, South Africa. witold.jacyk@up.ac.za
Bhana
K N
KN
D000328:Adult; D044383:Black People; D003955:Diagnostic Tests, Routine; D005260:Female; D006801:Humans; D008180:Lupus Erythematosus, Systemic / Q000150:complications; D015435:Panniculitis, Lupus Erythematosus / Q000175:diagnosis* / Q000473:pathology; D013019:South Africa