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1/9. Treatment of resistant discoid lupus erythematosus of the palms and soles with mycophenolate mofetil.

    Mycophenolate mofetil is an immunosuppressive drug that has recently been used to treat a variety of autoimmune and inflammatory skin diseases. Expanding the use of this agent in dermatology, we describe 2 patients with both systemic lupus erythematosus and discoid lupus erythematosus whose recalcitrant palmoplantar lesions were successfully treated with mycophenolate mofetil.
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2/9. Hereditary complement (C2) deficiency with discoid lupus erythematosus and idiopathic atrophoderma.

    A family with hereditary deficiency of the second component of complement was studied. Three siblings were homozygous for C2 deficiency and two of them had associated skin diseases. One sister presented with idiopathic atrophoderma and the other had clinical and pathological manifestations of discoid lupus erythematosus. This is the first description of an association between idiopathic atrophoderma and C2 deficient state.
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3/9. skin diseases in tropical africa. Medical, social, and economic implications.

    Diseases, ignorance, and poverty are linked in a vicious web in africa. Economic changes (foreign debts) and frequent political instability (eg, due to military coups), refugee influx, and industrialization have had profound effects on skin diseases. The interaction of these influences on skin diseases is discussed, and suggestions are made to bring about some improvement.
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keywords = skin disease
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4/9. Discoid lupus erythematosus-like skin lesions in a patient with autosomal recessive chronic granulomatous disease.

    A case of chronic granulomatous disease (CGD) in a 32-year-old female with two episodes of opportunistic infections is described. At the age of 29 the patient was suspected to be a carrier of X-linked CGD on the basis of discoid lupus erythematosus-like skin lesions. No respiratory burst activity, as measured by phorbol myristate acetate stimulated superoxide production, was observed in isolated neutrophils of the patient. Membrane-rich fractions elicited no superoxide production in the presence of NADPH. The neutrophil content of cytochrome b-245 was within normal range. family investigations revealed neither cellular abnormalities nor any history of skin diseases or opportunistic infections in first degree relatives. The parents of the patient were first cousins. On the basis of family history and the in-vitro assessment of neutrophil function, the patient is believed to have autosomal recessive CGD. The presented case illustrates that lupus erythematosus-like skin lesions are not restricted to female carriers of X-linked CGD, but may also be found in the autosomal recessive type of the disease.
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keywords = skin disease
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5/9. Eyelid involvement as the presenting manifestation of discoid lupus erythematosus.

    A case with discoid lupus erythematosus was diagnosed by a palpebral lesion as the initial manifestation of her disease. Lid skin biopsy confirmed the diagnosis. awareness to such unusual localization of discoid lupus erythematosus can lead to an early discovery of the skin disease.
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keywords = skin disease
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6/9. Discoid lupus erythematosus of the eyelids.

    Discoid lupus erythematosus (DLE) is a chronic skin disease that may affect the eyelids. Unless suspected, these lid lesions may resemble chronic blepharitis and persist for years. We present the clinicopathologic features of DLE from the lids of seven patients, electron microscopic features of one case, and a review of 31 previously reported cases.
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keywords = skin disease
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7/9. Concurrent localized scleroderma and discoid lupus erythematosus. Cutaneous 'mixed' or 'overlap' syndrome.

    Four patients with concurrent, chronic, progessive, localized scleroderma and discoid lupus erythematosus were studied; the condition originated as linear scleroderma in three of them. Three of the four patients were young females at the onset of the first skin disease. Dermatopathologic study confirmed the scleroderma and lupus erythematosus (LE). Direct immunofluorescence showed a positive band test in three cases. Unusual serological results included a positive LE clot test in three cases, a positive extractable nuclear antigen test in one case, and a negative antinuclear antibody test on repeated occasions in all four cases. Rare cutaneous disease similar to systemic, "mixed," or "overlap" connective tissue disease exists and offers an opportunity to study unusual immunologic and pathological events in both scleroderma and LE.
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8/9. Chronic cutaneous lupus erythematosus mimicking mycosis fungoides.

    mycosis fungoides, which is characterized by a malignant infiltrate of T lymphocytes involving the epidermis, can be confused with other inflammatory skin diseases. We report the case of a patient with skin lesions containing an infiltrate of atypical lymphocytes with epidermotropism. This patient's condition was initially diagnosed as mycosis fungoides. Repeated biopsy samples had the histologic features of chronic cutaneous lupus erythematosus. The patient had a strongly positive antinuclear antibody response and the clinical lesions responded to hydroxychloroquine, however, and these findings led to an altered diagnosis. Other disorders that either clinically or histologically mimic mycosis fungoides are reviewed, and the diagnostic evaluation of patients in whom mycosis fungoides is suspected is summarized. Chronic cutaneous lupus erythematosus should be added to the list of diseases that can mimic mycosis fungoides.
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keywords = skin disease
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9/9. An unusual ocular manifestation of discoid lupus erythematosus.

    BACKGROUND: Discoid lupus erythematosus is a chronic skin disease characterized by well-demarcated papules and plaques. mucous membrane changes are common; however, conjunctival involvement is unusual. We report a case of unilateral, chronic, isolated discoid lupus erythematosus of the conjunctiva. OBSERVATIONS: A 32-year-old man presented for evaluation of chronic conjunctivitis of the right eye that had persisted for 9 years. A biopsy of the bulbar conjunctiva revealed a mixed mononuclear cellular infiltrate distributed along the epithelial basement membrane zone and around the stromal blood vessels. Immunohistopathologic examination revealed a diffuse, granular pattern of fluorescence corresponding to immunoglobulins and complement components along the epithelial basement membrane zone and in the walls of the stromal blood vessels. Electron microscopy demonstrated changes in the epithelial basal lamina consistent with discoid lupus erythematosus, including areas that were multilayered. Immunoelectron microscopy identified sub-basal lamina deposits of immunoglobulin g. CONCLUSIONS: Discoid lupus erythematosus should be a suspected cause of chronic conjunctival inflammation; the diagnosis is substantiated by immunopathologic and ultrastructural studies.
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