Thai Journal of Dermatology

Sclerodermiform Lupus Erythematosus: A Case Report of an Overlap Syndrome of Lupus Profundus and Morphea

Wed, 06 Mar 2024 00:00:00 +0700

Sclerodermiform lupus erythematosus is a rare type 3 overlap syndrome between chronic cutaneous lupus erythematosus (CCLE) and morphea. The diagnostic criteria are shared histopathologic features of both CCLE and morphea. Here we reported a 49-year-old female presented with an indurated mass with intermittent pain on the left inner thigh for 3 years. Dermatological examination showed ill-defined hyperpigmented, indurated plaque with bound-down skin on the inner side of the left thigh. Skin biopsy revealed subcutaneous lobular lymphocytic infiltrate with lipomembranous and hyalinized fat necrosis mixed with thickened collagen. Alcian blue pH2.5 revealed an increase in dermal and subcutaneous mucin. Immunohistochemistry for CD123 was positive plasmacytoid dendritic cells in clusters. Serological studies showed positive antinuclear and anti-ds DNA antibodies. A diagnosis of sclerodermiform lupus erythematosus was made. Administration of prednisolone, methotrexate, and chloroquine resulted in gradually improved in 5 months. Previous reports of sclerodermiform lupus and morpheaform lupus were summarized.

Refractory Cutaneous Lymphoid Hyperplasia Treated with Rituximab: A Case Report and Literature Review

Yutarat Suwanchatkul, Manasmon Chairatchaneeboon — Wed, 06 Mar 2024 00:00:00 +0700

Cutaneous lymphoid hyperplasia (CLH), recognized as reactive B-cell-rich lymphoid proliferations in the 5th edition of the World Health Organization Classification of Haematolymphoid Tumours, is a benign reactive inflammatory condition that clinically and histologically resembles cutaneous lymphoma and can present with a predominance of B-cells, T-cells, or a mixture of both. The majority of patients present with a single papule, nodule, or plaque. Nevertheless, numerous or extensive lesions can rarely develop. We report a case of CLH with multiple nodules and plaques on the face. The patient had a progressive refractory disease and showed poor response to numerous therapies, including topical, intralesional, and systemic corticosteroids, topical calcineurin inhibitors, doxycycline, isotretinoin, hydroxychloroquine, and methotrexate, but showed a great response to rituximab, a monoclonal antibody targeted against the CD20 antigen.

Case Report: Subcutaneous Basidiobolomycosis in Pregnancy

Awasada Limtao, Patlada Ingkaninan — Wed, 06 Mar 2024 00:00:00 +0700

Subcutaneous basidiobolomycosis is an unusual fungal infection caused by Basidiobolus ranarum. The infection is typically painless, firm, and slowly enlargement nodules on extremities, buttock, and trunk. Diagnosis is based on clinical features, histopathology, and fungal culture. The disease is more common in children and males are more affected than females. However, there is limited information available on whether subcutaneous basidiobolomycosis occurs in pregnancy. We report a case of basidiobolomycosis in 32-year-old, 3^rd trimester pregnant female from Myanmar. Diagnosed is based on clinical features and histopathology. After delivery, she received intravenous amphotericin B for one month followed by oral itraconazole. Her left leg decreased in size and returned to normal after 5 months.

Rituximab-Induced Interstitial Lung Disease in Pemphigus Patients: Two Case Reports and Review of the Literature

Niporn Jariyakulwong, Julphat Intarasupht — Wed, 06 Mar 2024 00:00:00 +0700

Rituximab is a CD20-directed cytolytic antibody approved as a novel effective first-line treatment for severe pemphigus vulgaris and pemphigus foliaceus. Rituximab is generally safe, but uncommon fatal adverse events such as drug-induced interstitial lung disease have been reported. We reported two patients who developed rituximab-induced interstitial lung disease despite receiving the recommended standard dosages and review of the literature.

IgG4-Related Disease Presenting as Generalized Itchy Papules: A Case Report

Pichanun Sangchaisirisak, Ratchada Ongthawekiat, Patlada Ingkaninanda — Wed, 06 Mar 2024 00:00:00 +0700

IgG4-related disease (IgG4-RD) is an immune-mediated fibroinflammatory disease characterized by increased serum IgG4 and IgG4⁺ cell infiltrated tissues. Affected organs usually include the pancreas, biliary tract, retroperitoneum, aorta, salivary, and lacrimal glands. Cutaneous lesions are uncommon. IgG4-RD is treatable and highly responsive to glucocorticoids. This case report concerns a rare case of IgG4-RD presenting with generalized erythematous to brownish itchy papules and bilateral lacrimal gland masses with lung involvement including mediastinal lymphadenopathy, multiple lung nodules, and ground glass opacities in both lungs that responded to prednisolone and ciclosporin.