Lupus profundus/panniculitis

A 25-year-old Caucasian woman developed two areas of tender panniculitis on her left thigh. While one lesion ulcerated, the other showed no overlying cutaneous changes. Histological examination showed lymphocytic perivascular and periappendageal infiltrates, and direct immunofluorescence revealed granular immunoglobulin deposits at the dermal-epidermal junction in the skin overlying the lesions. Laboratory tests revealed lymphopenia, anemia and an increased blood sedimentation rate. The serology for syphilis was false positive. For several months the patient had also been suffering from arthralgia with palpable synovitis of the wrist and several interphalangeal joints. Overall, these clinical findings are consistent with the diagnosis of lupus profundus/panniculitis associated with mild systemic LE.