title: Prominent Degos-like skin lesions in a patient with chronic cutaneous lupus erythematosus.
abstract: Malignant atrophic papulosis, commonly known as Degos disease, is a rare vasculopathy encompassing both benign, cutaneous and lethal systemic variants. We report a case of chronic cutaneous lupus erythematosus in a 41-year-old male presenting with prominent Degos-like skin lesions. Multiple atrophic, porcelain-white, scar-like papules and plaques with dusky, erythematous borders, suggestive of malignant atrophic papulosis, were noted on the patient's back. Additional cutaneous findings included photo-distributed facial erythema and discoid lupus-like plaques on the face, shoulders, and arms. Clinicopathological correlation supported a diagnosis of chronic cutaneous lupus erythematosus; hydroxychloroquine was initiated with good clinical response. No new or active lesions were observed at the sixteen-month follow-up. This case highlights a rare skin finding associated with chronic cutaneous lupus erythematosus and underscores the importance of ruling out primary autoimmune disease, particularly lupus, before a diagnosis of malignant atrophic papulosis can be made.
authors.affiliation: Division of Dermatology, Washington University School of Medicine, St. Louis, Missouri, USA. mmutizwa@dom.wustl.edu
authors.forename: Misha M
authors.initials: MM
authors.lastname: Mutizwa
authors.forename: Mark B
authors.initials: MB
authors.lastname: Tang
authors.forename: See Ket
authors.initials: SK
authors.lastname: Ng
mesh_terms: D000328:Adult; D018501:Antirheumatic Agents / Q000627:therapeutic use; D001241:Aspirin / Q000627:therapeutic use; D003937:Diagnosis, Differential; D006801:Humans; D006886:Hydroxychloroquine / Q000627:therapeutic use; D008179:Lupus Erythematosus, Discoid / Q000150:complications / Q000175:diagnosis* / Q000188:drug therapy / Q000473:pathology; D008297:Male; D054853:Malignant Atrophic Papulosis / Q000150:complications / Q000175:diagnosis* / Q000188:drug therapy / Q000473:pathology; D016896:Treatment Outcome
chemical_list: D018501:Antirheumatic Agents; D006886:Hydroxychloroquine; D001241:Aspirin