Clinical, Histopathological, and Therapeutic Features in Lupus Erythematosus Tumidus: A Retrospective Study

Lupus erythematosus tumidus (LET) is a rare form of cutaneous lupus erythematosus (CLE) with a controversial connection to systemic lupus erythematosus (SLE). We conducted a retrospective study with 34 LET patients in a Spanish tertiary referral center from 2007 to 2019. Most were women [52.9% (18/3...

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Main Authors: E. La Rotta-Higuera, D. Morgado-Carrasco, M. Mansilla-Polo, P. Giavedoni, A. García-Herrera, J.M. Mascaró, Jr
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Language:English
Published: Elsevier 2025-06-01
Series:Actas Dermo-Sifiliográficas
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Online Access:http://www.sciencedirect.com/science/article/pii/S0001731025000729
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author E. La Rotta-Higuera
D. Morgado-Carrasco
M. Mansilla-Polo
P. Giavedoni
A. García-Herrera
J.M. Mascaró, Jr
author_facet E. La Rotta-Higuera
D. Morgado-Carrasco
M. Mansilla-Polo
P. Giavedoni
A. García-Herrera
J.M. Mascaró, Jr
author_sort E. La Rotta-Higuera
collection DOAJ
description Lupus erythematosus tumidus (LET) is a rare form of cutaneous lupus erythematosus (CLE) with a controversial connection to systemic lupus erythematosus (SLE). We conducted a retrospective study with 34 LET patients in a Spanish tertiary referral center from 2007 to 2019. Most were women [52.9% (18/34)], with a median age of 53.5 years. Autoimmune or rheumatologic disorders were reported in 52.9% (18/34) of cases, and other CLE variants in 26.5% (9/34). SLE occurred in 8.82% (3/34), while 64.7% (22/34) had autoantibodies. Immunohistochemical CD123 testing tested positive in 75.9% (22/34), while direct immunofluorescence (DIF) showed positivity in 31.8% (7/22) of cases. Treatment included topical agents (100%), antimalarials (73.5%), oral corticosteroids (23.5%), and immunosuppressants (14.7%). All achieved clinical remission, but a delayed response (>3 months) was linked to SLE (p = 0.002) and anti-DNA antibodies (p = 0.003).LET usually associates with autoimmune disorders and autoantibodies. CD123 and DIF aid diagnosis, and systemic treatment may be needed, especially with SLE and anti-DNA antibodies. Resumen: El lupus eritematoso túmido (LET) es una forma rara de lupus eritematoso cutáneo (LEC) con vínculos inciertos con el lupus eritematoso sistémico (LES). Estudiamos retrospectivamente a 34 pacientes con LET entre 2007 y 2019. La mayoría eran mujeres [52,9% 18/34)] (mediana de edad de 53,5 años). El 52,9% (18/34) presentaba trastornos autoinmunitarios o reumatológicos, y el 26,5% (9/34), otras variantes de LEC. Tres pacientes (8,2%) desarrollaron LES. El 64,7% (22/34) presentaba autoanticuerpos. La inmunohistoquímica de CD123 fue positiva en el 75,9% (22/34), y la inmunofluorescencia directa (IFD) en el 31,8% (7/22). El tratamiento incluyó agentes tópicos (100%), antipalúdicos (73,5%), corticosteroides orales (23,5%) y otros inmunosupresores (14,7%). Todos alcanzaron la remisión clínica. Una respuesta tardía (> 3 meses) se asoció a la presencia de LES (p = 0,002) y de anticuerpos anti-ADN (p = 0,003).El LET suele asociarse con trastornos autoinmunitarios y autoanticuerpos. CD123 e IFD podrían ser útiles para el diagnóstico. Puede requerirse tratamiento sistémico, especialmente en casos de LES y presencia de anticuerpos anti-ADN.
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spelling doaj-art-46384fd4cdd64a60b6d4ffca932971622025-08-20T02:32:04ZengElsevierActas Dermo-Sifiliográficas0001-73102025-06-01116662863210.1016/j.ad.2024.02.038Clinical, Histopathological, and Therapeutic Features in Lupus Erythematosus Tumidus: A Retrospective StudyE. La Rotta-Higuera0D. Morgado-Carrasco1M. Mansilla-Polo2P. Giavedoni3A. García-Herrera4J.M. Mascaró, Jr5Department of Dermatology, Hospital Clínic de Barcelona, Barcelona, SpainDepartment of Dermatology, Hospital Clínic de Barcelona, Barcelona, SpainDepartment of Dermatology, Hospital Universitario y Politécnico La Fe, Valencia, Spain; Instituto de Investigación Sanitaria (IIS) La Fe, Valencia, SpainDepartment of Dermatology, Hospital Clínic de Barcelona, Barcelona, SpainDepartment of Pathology, Hospital Clínic de Barcelona, Barcelona, SpainDepartment of Dermatology, Hospital Clínic de Barcelona, Barcelona, Spain; Corresponding author.Lupus erythematosus tumidus (LET) is a rare form of cutaneous lupus erythematosus (CLE) with a controversial connection to systemic lupus erythematosus (SLE). We conducted a retrospective study with 34 LET patients in a Spanish tertiary referral center from 2007 to 2019. Most were women [52.9% (18/34)], with a median age of 53.5 years. Autoimmune or rheumatologic disorders were reported in 52.9% (18/34) of cases, and other CLE variants in 26.5% (9/34). SLE occurred in 8.82% (3/34), while 64.7% (22/34) had autoantibodies. Immunohistochemical CD123 testing tested positive in 75.9% (22/34), while direct immunofluorescence (DIF) showed positivity in 31.8% (7/22) of cases. Treatment included topical agents (100%), antimalarials (73.5%), oral corticosteroids (23.5%), and immunosuppressants (14.7%). All achieved clinical remission, but a delayed response (>3 months) was linked to SLE (p = 0.002) and anti-DNA antibodies (p = 0.003).LET usually associates with autoimmune disorders and autoantibodies. CD123 and DIF aid diagnosis, and systemic treatment may be needed, especially with SLE and anti-DNA antibodies. Resumen: El lupus eritematoso túmido (LET) es una forma rara de lupus eritematoso cutáneo (LEC) con vínculos inciertos con el lupus eritematoso sistémico (LES). Estudiamos retrospectivamente a 34 pacientes con LET entre 2007 y 2019. La mayoría eran mujeres [52,9% 18/34)] (mediana de edad de 53,5 años). El 52,9% (18/34) presentaba trastornos autoinmunitarios o reumatológicos, y el 26,5% (9/34), otras variantes de LEC. Tres pacientes (8,2%) desarrollaron LES. El 64,7% (22/34) presentaba autoanticuerpos. La inmunohistoquímica de CD123 fue positiva en el 75,9% (22/34), y la inmunofluorescencia directa (IFD) en el 31,8% (7/22). El tratamiento incluyó agentes tópicos (100%), antipalúdicos (73,5%), corticosteroides orales (23,5%) y otros inmunosupresores (14,7%). Todos alcanzaron la remisión clínica. Una respuesta tardía (> 3 meses) se asoció a la presencia de LES (p = 0,002) y de anticuerpos anti-ADN (p = 0,003).El LET suele asociarse con trastornos autoinmunitarios y autoanticuerpos. CD123 e IFD podrían ser útiles para el diagnóstico. Puede requerirse tratamiento sistémico, especialmente en casos de LES y presencia de anticuerpos anti-ADN.http://www.sciencedirect.com/science/article/pii/S0001731025000729Lupus eritematoso túmidoLupus cutáneo eritematosoLupus eritematoso sistémicoCD123Inmunofluorescencia directaTrastornos autoinmunes
spellingShingle E. La Rotta-Higuera
D. Morgado-Carrasco
M. Mansilla-Polo
P. Giavedoni
A. García-Herrera
J.M. Mascaró, Jr
Clinical, Histopathological, and Therapeutic Features in Lupus Erythematosus Tumidus: A Retrospective Study
Actas Dermo-Sifiliográficas
Lupus eritematoso túmido
Lupus cutáneo eritematoso
Lupus eritematoso sistémico
CD123
Inmunofluorescencia directa
Trastornos autoinmunes
title Clinical, Histopathological, and Therapeutic Features in Lupus Erythematosus Tumidus: A Retrospective Study
title_full Clinical, Histopathological, and Therapeutic Features in Lupus Erythematosus Tumidus: A Retrospective Study
title_fullStr Clinical, Histopathological, and Therapeutic Features in Lupus Erythematosus Tumidus: A Retrospective Study
title_full_unstemmed Clinical, Histopathological, and Therapeutic Features in Lupus Erythematosus Tumidus: A Retrospective Study
title_short Clinical, Histopathological, and Therapeutic Features in Lupus Erythematosus Tumidus: A Retrospective Study
title_sort clinical histopathological and therapeutic features in lupus erythematosus tumidus a retrospective study
topic Lupus eritematoso túmido
Lupus cutáneo eritematoso
Lupus eritematoso sistémico
CD123
Inmunofluorescencia directa
Trastornos autoinmunes
url http://www.sciencedirect.com/science/article/pii/S0001731025000729
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