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Dermoscopy Aids in the Diagnosis of Discoid Lupus Erythematosus
Published on: May 16, 2025
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Localised chronic fibrosing vasculitis versus erythema elevatum diutinum
Mika M Tabata1, William M Lin2, Jay Goldstein3
1Dermatology, UT Austin, Austin, Texas, USA.
BMJ Case Reports
|January 2, 2023
Summary
A rare skin condition, localized chronic fibrosing vasculitis, presented as a thick plaque. Treatment with dapsone showed plaque improvement, suggesting its potential efficacy.
Area of Science:
- Dermatology
- Pathology
- Immunology
Background:
- Localized chronic fibrosing vasculitis is a rare skin disease.
- It typically presents as ulcerated nodules and can be histologically similar to erythema elevatum diutinum (EED).
Observation:
- A woman in her 70s presented with a painless, progressing plaque on her shin.
- The plaque was erythematous, violaceous, indurated, and had a cobblestone appearance.
Findings:
- Biopsy revealed a localized chronic fibrosing vasculitis with neutrophils, mixed inflammatory cells, lamellar fibrosis, and vascular damage.
- Histological features were noted to be similar to EED, which often presents with neutrophils and granulomas.
Implications:
- Dapsone, a treatment for EED, was administered due to observed similarities and neutrophil presence.
- The patient showed plaque improvement, suggesting dapsone as a potential treatment for localized chronic fibrosing vasculitis.
- Further research is needed due to the rarity of this condition and lack of established treatment guidelines.
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