title: Papulonodular mucinosis indicating systemic lupus erythematosus.
abstract: We describe an 18-year-old girl with systemic lupus erythematosus (SLE) who had cutaneous papulonodular mucinosis (PNM) as the first sign of SLE. She presented with multiple flesh-coloured papules on the face, abdomen and limbs. Histological examination of a biopsy taken from a papule showed diffuse deposition of mucin throughout the dermis, and direct immunofluorescence of lesional skin showed a dermoepidermal junction band composed of IgG, IgM and C3, consistent with PNM. Investigations showed that that the patient had leucopenia, positive antinuclear and anti-double-stranded DNA antibodies and lupus nephritis. PMN can be an unusual clinical presentation of SLE.
authors.affiliation: Department of Dermatology, Razi Hospital, Tehran, Iran.
authors.forename: A Mir
authors.initials: AM
authors.lastname: Shekari
authors.forename: M
authors.initials: M
authors.lastname: Ghiasi
authors.forename: E
authors.initials: E
authors.lastname: Ghasemi
authors.forename: Z Asadi
authors.initials: ZA
authors.lastname: Kani
mesh_terms: D000293:Adolescent; D000906:Antibodies / Q000032:analysis; D004247:DNA / Q000276:immunology; D005260:Female; D006801:Humans; D008180:Lupus Erythematosus, Systemic / Q000150:complications* / Q000473:pathology; D017520:Mucinoses / Q000209:etiology* / Q000473:pathology; D009077:Mucins / Q000378:metabolism*
chemical_list: D000906:Antibodies; D009077:Mucins; D004247:DNA