Sjogren's Syndrome Presenting with Solely Cutaneous Features

Area of Science:

• Dermatology
• Rheumatology
• Immunology

Background:

• Sjogren's syndrome classically presents with dry eyes (keratoconjunctivitis sicca) and dry mouth (xerostomia).
• Lymphocytic infiltration of salivary and lacrimal glands is the typical pathology.
• Cutaneous manifestations are often overlooked, especially in patients lacking classic symptoms.

Observation:

• A 56-year-old Asian female presented with intermittent erythematous lesions on her ears.
• Initial differential diagnoses included tumid lupus, cutaneous T-cell lymphoma, and relapsing polychondritis.
• Extensive workup, including serologic and histopathologic studies, was performed.

Findings:

• The patient's presentation, initially concerning for other conditions, was ultimately diagnosed as Sjogren's syndrome.
• This case highlights that Sjogren's syndrome can present primarily with extraglandular cutaneous symptoms.
• The diagnosis was confirmed through comprehensive diagnostic evaluation.

Implications:

• Sjogren's syndrome is a multi-systemic autoimmune disease with diverse clinical presentations.
• Physicians must maintain a broad differential diagnosis for patients with unexplained cutaneous symptoms.
• Awareness of autoimmune overlap syndromes is crucial for accurate patient diagnosis and management.