[症例報告]A case report of hyperkeratotic lupus erythmatosus : An electron microscopic study of hyperkeratotic lesion

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We report a case of hyperkeratotic lupus erythmatosus (LE) occurring on the dorsum of the right hand and the forearm of a 47-year old construction worker. Clinically, the hyperkeratotic LE lesions were scaly, revealing an indurated brownish margin and a wart-like appearance. Histopathologically, marked hyperkeratosis and acanthosis at the epidermis and solar elastosis of the upper dermis were observed. Serum immunoglobulins (IgG.IgA.IgM,) levels were increased, but there was no deposition of the immunoglobulins at the dermoepidermal junction in direct immunoflourescence examination. Electron microscopically the epidermal basement membrane was thick and partially multilayered, whereas the blood vessel walls were thickened and multilayered at the dermis. The collagen fibers were also thick and abundant, with many fibroblasts present at the upper dermis near the basement membrane zone. From these findings, we concluded that long term exposures to sun light might have damaged the photosensitive skin of LE patient. After repeated damage and repair, the collagen fibers had become thick and abundant with many fibroblasts at the upper dermis. Wecompared our case with those of Systemic Lupus Erythmatosus (SLE) and Discoid Lupus Erythmatosus (DLE) using electron microscopic and immunohistochemical techniques. We could not determine why some DLE patients show wart-like lesions while others do not.
琉球医学会の論文
1997-00-00