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Lupus and leg ulcers--a diagnostic quandary
Venkat Reddy1, Magdalena Dziadzio, Shahir Hamdulay
1Arthritis Centre, Northwick Park Hospital, Watford Road, London HA1 3UJ, UK, Magdalena.Dziadzio@nwlh.nhs.uk
Clinical Rheumatology
|April 25, 2006
Summary
Systemic lupus erythematosus (SLE) can cause leg ulcers. This case highlights pyoderma gangrenosum (PG) in an SLE patient without antiphospholipid antibodies, linked to disease reactivation.
Area of Science:
- Rheumatology
- Dermatology
- Immunology
Background:
- Leg ulcerations are known complications in patients with systemic lupus erythematosus (SLE), particularly those with antiphospholipid (aPL) antibodies or vasculitis.
- Antiphospholipid antibodies are suspected to contribute to the pathogenesis of skin manifestations in SLE.
- Previous reports include a single case of aPL antibody-negative pyoderma gangrenosum (PG) preceding an SLE diagnosis.
Observation:
- This report details a young male SLE patient who presented with leg ulcers.
- The leg ulcers were diagnosed as pyoderma gangrenosum (PG).
- Crucially, the patient was negative for aPL antibodies.
Findings:
- The onset of PG in this SLE patient was concurrent with a reactivation of their underlying SLE.
- The patient's leg lesions showed significant improvement following effective treatment.
- Treatment also led to a reduction in overall SLE disease activity.
Implications:
- This case underscores that pyoderma gangrenosum can manifest in SLE patients even without antiphospholipid antibodies.
- The findings suggest a potential link between SLE reactivation and the development or exacerbation of PG.
- Effective management of SLE activity may be crucial for improving cutaneous manifestations like PG in affected patients.
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