Medicina Fluminensis, Vol. 61 No. 1, 2025.
Studija slučaja
https://doi.org/10.21860/medflum2025_323591
Comedones and Atrophic Scarring as a Rare Presentation of Chronic Cutaneous Lupus Erythematosus – a Case Report
Leona Ostojić
; Sveučilište u Rijeci, Medicinski fakultet, Rijeka, Hrvatska
Sandra Peternel
orcid.org/0000-0001-8590-0451
; Sveučilište u Rijeci, Medicinski fakultet, Rijeka, Hrvatska; Klinički bolnički centar Rijeka, Klinika za dermatovenerologiju, Rijeka, Hrvatska
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* Dopisni autor.
Sažetak
Aim: To present a case of a patient with comedonal lupus, an exceptionally rare form of chronic cutaneous lupus erythematosus (CCLE). Emphasis is placed on the clinical presentation and diagnostic challenges associated with this condition. Case report: A 37-year-old woman presented to the dermatology clinic with an erythematous infiltration localized on the left side of her chin, accompanied by open comedones. Additionally, periauricular atrophic scarring and darker comedones were noted. Initially, a diagnosis of a subacute abscess was made, and the patient was prescribed antibiotic therapy with planned further surgical treatment. However, a change in the lesion’s appearance prompted suspicion of the initial diagnosis, resulting in an incisional biopsy. After correlating clinical presentation, histopathological findings, and laboratory results, the patient was diagnosed with the comedonal variant of CCLE. Treatment with hydroxychloroquine, along with intralesional injection of triamcinolone, was initiated. After the onset of macular changes, hydroxychloroquine was replaced with methotrexate. Three months later, the dose of methotrexate was increased due to persistent erythema and edema of the lesion, and intralesional triamcinolone therapy was intensified, resulting in improvement of the clinical picture over six months. Conclusion: Comedonal lupus is an extremely rare subtype of CCLE. This report represents the 20th documented case, highlighting the diagnostic and therapeutic challenges due to the lack of typical dermatological features and uncertainty of prognosis. Histopathological analysis and correlation with the clinical presentation are crucial for confirming the diagnosis. Timely diagnosis is essential, along with an individualized therapeutic approach and continuous patient monitoring for the possibility of progression to systemic disease.
Ključne riječi
acneiform eruptions; lupus erythematosus, cutaneous; lupus erythematosus, systemic
Hrčak ID:
323591
URI
Datum izdavanja:
1.3.2025.
Posjeta: 242 *