Clinical utility of computed tomographic scanning for the evaluation of lupus profundus in two patients with systemic lupus erythematosus.
Lupus profundus is a rare lupus-specific skin lesion with skin biopsies exhibiting lobular lymphocytic infiltration and destruction of subcutaneous fat tissue. In this report, a CT scan was effective in demonstrating both the presence and the extent of inflammation of lupus profundus in two patients with systemic lupus erythematosus (SLE). Case 1 was a 30-year-old woman developing erythema with subcutaneous induration on the upper arms during the quiescent phase of SLE. A skin biopsy confirmed a diagnosis of lupus profundus. A CT scan of the right upper arm demonstrated a high density area (HDA) of the subcutis under the erythema: a finding consistent with lupus profundus. Case 2 was a 28-year-old woman recently diagnosed with SLE. She also developed a skin ulcer on the right hip. A CT scan of the hip revealed an HDA and lipoatrophy of the subcutis around the ulcer: these findings were compatible with lupus profundus. Treatment with high-dose prednisolone improved the illness in the both cases. A CT scan is a useful and convenient imaging modality for confirming the diagnosis of lupus profundus.
Institute of Rheumatology, Aoyama Hospital, Tokyo Women's Medical University, 2-7-13 Kitaaoyama, Minato-ku, Tokyo, 107-0061, Japan. kintarou@s9.dion.ne.jp
Takashi
T
Kato
Ayako
A
Nakajima
Tokiko
T
Kanno
Mikiko
M
Shinozaki
Takahisa
T
Gono
Hisae
H
Ichida
Ikuko
I
Masuda
Naoyuki
N
Kamatani
Masako
M
Hara
D000328:Adult; D003937:Diagnosis, Differential; D005260:Female; D006801:Humans; D008180:Lupus Erythematosus, Systemic / Q000150:complications / Q000000981:diagnostic imaging*; D015435:Panniculitis, Lupus Erythematosus / Q000150:complications / Q000000981:diagnostic imaging*; D014057:Tomography, X-Ray Computed / Q000706:statistics & numerical data*