Lupus erythematosus panniculitis(profoundus)

A 39 year-old man developed on trunk, buttock and thighs scaling, atrophic, erythematous lesions which in some places became infiltrated and ulcerated. The clinical, histopathological and immunlogical picture corresponded with the diagnosis of discoid lupus erythematosus. In sites of infiltrations and necrosis, however, histological features of panniculitis with proliferative and inflammatory changes of deep vessels could be seen. The direct immunofluorescence of uninvolved skin showed deposits of IgM and C3 at the dermal-epidermal junction and within the vessel walls. The patient responded promptly to treatment with chloroquine.