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Papulonodular mucinosis indicating systemic lupus erythematosus
A Mir Shekari1, M Ghiasi, E Ghasemi
1Department of Dermatology, Razi Hospital, Tehran, Iran.
Clinical and Experimental Dermatology
|June 4, 2009
Summary
Systemic lupus erythematosus (SLE) can present with cutaneous papulonodular mucinosis (PNM) as an initial symptom. This case highlights PNM as an unusual early indicator of SLE in an 18-year-old female.
Area of Science:
- Dermatology
- Rheumatology
- Immunology
Background:
- Systemic lupus erythematosus (SLE) is a chronic autoimmune disease with diverse clinical manifestations.
- Cutaneous manifestations are common in SLE, but papulonodular mucinosis (PNM) is an infrequent presentation.
Observation:
- An 18-year-old female presented with multiple flesh-colored papules on her face, abdomen, and limbs.
- Histopathology revealed diffuse dermal mucin deposition, and direct immunofluorescence showed a dermoepidermal junction band of IgG, IgM, and C3.
- These findings were consistent with PNM.
Findings:
- The patient was diagnosed with SLE, exhibiting leucopenia, positive antinuclear antibodies (ANA), anti-double-stranded DNA (anti-dsDNA) antibodies, and lupus nephritis.
- Cutaneous papulonodular mucinosis was the initial presenting sign of SLE in this patient.
Implications:
- PNM should be considered as a potential early cutaneous manifestation of SLE.
- This case underscores the importance of thorough investigation for underlying autoimmune diseases in patients presenting with unusual dermatological conditions.
- Recognizing PNM as an SLE sign can lead to earlier diagnosis and management of the systemic disease.
