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Vacuolar Interface Dermatitis as a Histologic Reaction Pattern of Sjögren's Syndrome: A Case Report
Georges El Hasbani1, Abdul-Ghani Kibbi2, Ali Jawad3
1Medicine, St. Vincent's Medical Center, Bridgeport, USA.
Cureus
|November 6, 2023
Summary
Sjögren's syndrome (SS) can present with skin issues like itchy plaques. This case highlights vacuolar interface dermatitis as a rare skin manifestation effectively treated with hydroxychloroquine.
Area of Science:
- Dermatology
- Rheumatology
- Immunology
Background:
- Sjögren's syndrome (SS) typically presents with dry eyes and dry mouth.
- Extraglandular manifestations of SS can be diverse and challenging, particularly when classic symptoms are absent.
- Cutaneous involvement in SS is variable and can be the initial presenting sign.
Observation:
- A rare case of an 87-year-old male with widespread, itchy, erythematous, scaly plaques is presented.
- The patient's skin condition was refractory to topical corticosteroids and medication adjustments.
- Skin biopsy revealed vacuolar interface dermatitis with positive anti-SSA antibodies.
Findings:
- Vacuolar interface dermatitis, typically associated with dermatomyositis and lupus erythematosus, was diagnosed in the context of Sjögren's syndrome.
- The patient tested positive for anti-SSA antibodies, further supporting the diagnosis.
- Treatment with hydroxychloroquine led to the resolution of the cutaneous plaques.
Implications:
- This case expands the understanding of extraglandular manifestations of Sjögren's syndrome.
- It underscores the importance of considering SS in patients with unexplained dermatological conditions like vacuolar interface dermatitis.
- Hydroxychloroquine emerges as a potential therapeutic option for managing cutaneous SS manifestations.
