Verrucous lupus erythematosus

A rare form of chronic cutaneous lupus erythematosus

Template:Medical condition (new)

Verrucous lupus erythematosus is a rare variant of chronic cutaneous lupus erythematosus (CCLE), characterized by the presence of wart-like lesions on the skin. This condition is a subtype of discoid lupus erythematosus (DLE), which is a form of lupus that primarily affects the skin.

Clinical Presentation

Verrucous lupus erythematosus presents with hyperkeratotic, verrucous plaques that are often found on sun-exposed areas of the skin. These lesions are typically thickened and may resemble verruca vulgaris (common warts), hence the name "verrucous." The lesions are usually chronic and can lead to scarring if not treated appropriately.

Pathophysiology

The exact pathophysiology of verrucous lupus erythematosus is not fully understood, but it is believed to involve an autoimmune response where the body's immune system attacks its own skin cells. This results in inflammation and the characteristic skin changes. Like other forms of lupus erythematosus, it is thought to be triggered by a combination of genetic, environmental, and hormonal factors.

Diagnosis

Diagnosis of verrucous lupus erythematosus is primarily clinical, supported by histopathological examination of a skin biopsy. The biopsy typically shows features of lupus erythematosus, such as interface dermatitis, thickening of the basement membrane, and a perivascular lymphocytic infiltrate. Direct immunofluorescence may reveal deposition of immunoglobulins and complement at the dermoepidermal junction.

Treatment

Treatment of verrucous lupus erythematosus involves the use of topical and systemic therapies to reduce inflammation and prevent progression. Topical corticosteroids and calcineurin inhibitors are commonly used. In more severe cases, systemic treatments such as antimalarials (e.g., hydroxychloroquine) or immunosuppressive agents may be necessary. Sun protection is also crucial to prevent exacerbation of the lesions.

Prognosis

The prognosis for verrucous lupus erythematosus varies. While some patients may achieve good control of their symptoms with treatment, others may experience chronic lesions that can lead to scarring and disfigurement. Regular follow-up with a dermatologist is important to monitor the condition and adjust treatment as needed.

Related Pages

• Lupus erythematosus
• Discoid lupus erythematosus
• Chronic cutaneous lupus erythematosus
• Autoimmune disease