title: Unilateral unique Lupus tumidus: pathogenetic mystery and diagnostic problem.
abstract: Lupus tumidus is a rare immunological disorder whose pathogenesis is not fully understood. Although on the one hand there are some differences in (1) the clinical morphology of lesions, (2) the histopathology picture, as well as in (3) serological profile of lupus tumidus patients at the current moment, the disease is regarded as a subform of chronic cutaneous lupus erythematosus. Differential diagnosis requires the exclusion of many diseases such as Jessner Kanoff lymphocytic infiltration, polymorphous light eruption, and reticular erythematous mucinosis. Differentiation between them is not always easy. The standard treatment regimen of patients with lupus tumidus is based on local and systemic application of corticosteroids, azathioprin, dapsone, mepacrine, chloroquine, and hydroxychloroquine. Modern treatment options include the use of pulsed dye laser, tacrolimus 0.1 % ointment and photophoresis. We present a 42-year-old patient with unilateral atypical form of lupus tumidus who was successfully treated with systematically administration of hydroxychloroquine in combination with sunscreen SPF 50. After a 2-month course of treatment with hydroxychloroquine dosage of 200 mg per day and a break of 3 months between courses, we observed a complete remission.
authors.affiliation: Medical College, Medical University of Varna, 84 Tzar Osvoboditel str., 9000, Varna, Bulgaria.
authors.forename: Ilko
authors.initials: I
authors.lastname: Bakardzhiev
authors.affiliation: "Onkoderma"-Policlinic for Dermatology and Dermatologic Surgery, General Skobelev 26 blvd., Sofia, Bulgaria.
authors.forename: Anastasiya Atanasova
authors.initials: AA
authors.lastname: Chokoeva
authors.affiliation: Department of Pathology, Medical University of Varna, Varna, Bulgaria.
authors.forename: Ivan
authors.initials: I
authors.lastname: Krasnaliev
authors.affiliation: Internal Medicine Unit, Guastalla Hospital, Ausl Reggio Emilia, Reggio Emilia, Italy.
authors.forename: Claudio
authors.initials: C
authors.lastname: Tana
authors.affiliation: Department of Dermatology and Allergology, Academic Teaching Hospital Dresden-Friedrichstadt, Dresden, Germany.
authors.forename: Uwe
authors.initials: U
authors.lastname: Wollina
authors.affiliation: University of Rome "G.Marconi", Rome, Italy.
authors.forename: Torello
authors.initials: T
authors.lastname: Lotti
authors.affiliation: Policlinic for Dermatology and Venereology, University Hospital Lozenetz, Koziak street 1, 1407, Sofia, Bulgaria. georgi_tchernev@yahoo.de.
authors.forename: Georgi
authors.initials: G
authors.lastname: Tchernev
mesh_terms: D000305:Adrenal Cortex Hormones / Q000627:therapeutic use; D000328:Adult; D001379:Azathioprine / Q000627:therapeutic use; D001706:Biopsy; D002738:Chloroquine / Q000627:therapeutic use; D003131:Combined Modality Therapy; D003622:Dapsone / Q000627:therapeutic use; D003937:Diagnosis, Differential; D006801:Humans; D006886:Hydroxychloroquine / Q000627:therapeutic use; D054025:Lasers, Dye / Q000627:therapeutic use; D008179:Lupus Erythematosus, Discoid / Q000175:diagnosis* / Q000188:drug therapy / Q000473:pathology; D008297:Male; D009824:Ointments; D011796:Quinacrine / Q000627:therapeutic use; D012867:Skin / Q000473:pathology; D013473:Sunscreening Agents / Q000627:therapeutic use; D016559:Tacrolimus / Q000627:therapeutic use
chemical_list: D000305:Adrenal Cortex Hormones; D009824:Ointments; D013473:Sunscreening Agents; D006886:Hydroxychloroquine; D002738:Chloroquine; D003622:Dapsone; D011796:Quinacrine; D001379:Azathioprine; D016559:Tacrolimus
keywords: Desquamation; Histopathology; Lupus tumidus; Treatment; Unilateral