Lupus erythematosus panniculitis

A young woman had a history of subcutaneous nodules, migratory arthralgia, myalgia, and lymphadenopathy. Histopathologic characteristics of the nodular subcutaneous lesion showed a massive lobular panniculitis characteristic of lupus erythematosus (LE) panniculitis. The diagnosis of LE panniculitis was established by demonstration of a positive linear basement membrane zone stain of the involved skin by direct immunofluorescence microscopy. Initial serologic findings showed negative antinuclear antibody (ANA) and anti-DNA antibody test results and a negative LE cell preparation. Subsequently, a positive ANA test result developed. The test result for extractable nuclear antigen was strongly positive, although initial test results for antibodies to ribonucleoprotein and Sm antigens were negative.