Korean J Dermatol.  2016 Dec;54(10):807-810.

Non-bullous Neutrophilic Dermatosis in a Patient with Lupus Nephritis

Affiliations
  • 1Department of Dermatology, Pusan National University School of Medicine, Busan, Korea. smargie@hanamil.net
  • 2Biomedical Research Institute, Pusan National University Hospital, Busan, Korea.

Abstract

Neutrophilic infiltrates of skin in the setting of lupus patients with bullous systemic lupus erythematosus (SLE) and leukocytoclastic vasculitis are well documented. However, most dermatology studies do not consider cutaneous involvement by SLE in the histologic differential diagnosis of neutrophilic inflammatory dermatosis in non-bullous or non-vasculitic lesions. Nevertheless, an increasing number of studies have reported cell-rich or Sweet's-like neutrophilic reactions as well as patients with skin lesions characterized by paucicellular neutrophilic dermal infiltrates. A 56-year-old female patient with history of lupus nephritis presented with multiple erythematous to brownish papulo-patches and plaques on both legs for 1 month. She had no signs or systemic symptoms of Sweet's syndrome. Histopathologic finding showed perivascular and interstitial neutrophilic infiltration with leukocytoclasia in the upper dermis, but not as dense as commonly observed in Sweet's syndrome with absence of papillary dermal edema. Herein, we present a rare case of non-bullous neutrophilic dermatosis associated with SLE. It is important to consider SLE-associated neutrophilic dermatosis in the differential diagnosis of neutrophilic tissue reactions and to be aware of the broad histologic spectrum that may be encountered in SLE-associated neutrophilic dermatosis, ranging from subtle paucicellular lesions to florid Sweet's-like lesions.

Keyword

Lupus nephritis; Non-bullous neutrophilic dermatosis; Non-bullous neutrophilic lupus erythematosus; Systemic lupus erythematosus

MeSH Terms

Dermatology
Dermis
Diagnosis, Differential
Edema
Female
Humans
Leg
Lupus Erythematosus, Systemic
Lupus Nephritis*
Middle Aged
Neutrophils*
Skin
Skin Diseases*
Sweet Syndrome
Vasculitis
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