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1/216. Coexistence of discoid lupus erythematosus and porphyria cutanea tarda.

    A case of coexistent porphyria cutanea tarda and discoid lupus erythematosus is presented. Abnormal urinary porphyrins, the presence of liver fluorescence, chronic alcoholism, fatty metamorphosis of the liver and histologically typical LE with the demonstration of basement membrane fluorescence were present in the patient. awareness of the possible coexistence of these two conditions is of practical significance for the practicing dermatologist. The nature of the relationship between these conditions remains obscure. Is it coincidental or does it represent a common pathophysiological mechanism? Further work on this unique pair of diseases seems indicated. ( info)

2/216. Lupus erythematosus exacerbated by griseofulvin.

    Because griseofulvin is one of the safest systemic medications, its side effects are often forgotten. This paper serves as a reminder that griseofulvin can precipitate or exacerbate lupus erythematosus. Two patients are described: one had a photosensitivity reaction to griseofulvin which precipitated discoid LE skin lesions, without any previous evidence of LE. The other, who had known systemic LE, developed a systemic reaction, consisting of fever and malasise. ( info)

3/216. A case of subcutaneous infection in a patient with discoid lupus erythematosus caused by a Scytalidium synanamorph of Nattrassia mangiferae, and its treatment.

    A case of subcutaneous infection caused by Scytalidium synanamorph of Nattrassia mangiferae is reported in a 24-year-old female suffering from subacute discoid lupus erythematosus. Lesions were seen on the palm of the left hand and dorsal aspect of the right hand. Histopathology of the biopsied specimen revealed light brown hyphae and single celled structures along with many inflammatory cells. The patient showed marked improvement with oral chloroquin and itraconazole orally and ketoconazole cream topically. ( info)

4/216. Jessner's lymphocytic infiltrate and probable discoid lupus erythematosus occurring separately in two sisters.

    We describe two sisters with clinical and histological features suggestive of Jessner's lymphocytic infiltrate in one and discoid lupus erythematosus in the other. The occurrence of these two entities in one family now gives credence to the theory that Jessner's lymphocytic infiltrate is in the same disease spectrum as lupus and probably also polymorphic light eruption. ( info)

5/216. Hypertrophic discoid lupus erythematosus of the conjunctiva.

    PURPOSE: To report the ophthalmic manifestations of hypertrophic discoid lupus erythematosus of the conjunctiva. METHOD: Case report and review of biopsy results. RESULTS: A 58-year-old woman with a history of chronic blepharoconjunctivitis presented with an unusual raised conjunctival lesion. Previous biopsy slides were reviewed and interpreted as diagnostic of discoid lupus erythematosus, hypertrophic or verrucous type. Both blepharoconjunctivitis and the raised conjunctival lesion resolved with hydroxychloroquine therapy. CONCLUSIONS: A raised conjunctival mass in the context of refractory blepharoconjunctivitis should elicit suspicion for discoid lupus erythematosus. The hypertrophic variant of this disease can affect the conjunctiva. ( info)

6/216. Linear childhood discoid lupus erythematosus following the lines of Blaschko: a case report with review of the linear manifestations of lupus erythematosus.

    Seventeen cases of childhood discoid lupus erythematosus (DLE) have been previously reported in the literature. We describe the first reported case of childhood linear DLE following the lines of Blaschko. The clinical and histologic characteristics of childhood DLE are discussed and a review of the linear manifestations of childhood LE is presented. ( info)

7/216. A case of SLE with acute, subacute and chronic cutaneous lesions successfully treated with dapsone.

    We describe a patient with systemic lupus erythematosus (SLE) who exhibited severe cutaneous involvement characterized by the simultaneous presence of acute, subacute and discoid lesions in association with anti-S1 antibodies. After she failed to respond to chloroquine, medium to low dose steroids, steroid pulses, retinoids and cyclophosphamide, the patient was treated with dapsone and a dramatic improvement in the cutaneous lesions was seen after only one month. ( info)

8/216. Complete heart block as a rare complication of treatment with chloroquine.

    antimalarials are well established disease modifying antirheumatic drugs. A rare and underappreciated treatment difficulty is cardiac complication, in particular conduction disturbances. We describe 2 more patients that developed complete heart block after high dose, longterm treatment. Patient 1, a 73-year-old woman with longstanding rheumatoid arthritis, had taken chloroquine (250 mg/day) for 12 years when she developed complete heart block requiring a permanent pacemaker. Patient 2, a 40-year-old woman with discoid lupus erythematosus, was taking chloroquine from 1979 until 1996. Depending on the clinical disease activity, she intermittently increased the dose from 250 to 750 mg/day. In 1994, she developed complete heart block and a permanent pacemaker had to be implanted. Intensive investigations in both cases did not reveal another underlying cause for conduction disturbances; the atrioventricular block was probably due in both cases to chloroquine related cardiac toxicity. This toxicity seems to be restricted to longterm, high dose treatment; however, it should be kept in mind in patients with preexisting conduction disturbances during longterm treatment. ( info)

9/216. collagen vascular diseases and radiation therapy: a critical review.

    PURPOSE: Although many oncologists have the impression that patients with collagen vascular disease tolerate radiotherapy less well than other patients, until now this was never described in a review article. methods AND RESULTS: The principal objective was to determine whether patients with collagen vascular diseases have a greater risk of severe radiation therapy complications, than those without a collagen vascular disease. However, most of the publications found on this topic are short anecdotal case reports of patients with increased toxicity after radiation. Consequently, the true incidence of these side effects is unknown. CONCLUSIONS: Unless further studies on this subject are reported, each radiation oncologist should be cautious in treating these patients. ( info)

10/216. Lupus tumidus.

    Lupus tumidus is a rare subtype of chronic cutaneous lupus erythematosus that was first described by Gougerot and Bournier in 1930. Clinically, lupus tumidus presents as smooth, shiny, red-violet plaques of the head and neck that may be pruritic and have a fine scale. These lesions characteristically clear without scarring and recur in their original distribution. Histologic features include superficial and deep lymphohistiocytic infiltrates and abundant dermal deposits of mucin. We describe lupus tumidus as a distinct form of cutaneous lupus erythematosus and report 4 cases. ( info)
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