Systemic lupus erythematosus associtated with an active persisting discoid lesion successfully treated by skin transplantion.

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A housewife who started with disseminated discoid lupus erythematosus at the age of 53 years developed hemolytic anemia and thrombocytopenia associated with disseminated discoid lesions, hair loss in the scalp, photosensitivity and cotton-wool exudate and superficial hemorrhage in ocular fundus and was diagnosed as systemic lupus erythematosus. This patient also had chronic hepatitis and pancreatitis. These symptoms were well controled with oral corticosteroid. However, during the course of 10 years a discoid lesion on the back of the hand persisted, increasing in size and thickness and often ulcerating and this lesion did not respond to the higher dose of corticosteroid. The lesions showed a lichenoid appearance and was also histologically lichen planus rather than discoid lupus erythematosus. This lesion was excised totally and a full-thickness inguinal skin was transplanted. The lesion relapsed in the periphery of transplanted skin in two occasions but this was treated by retransplantation in each occasion. The dose of oral corticosteroid could be reduced after skin transplantation.
日本皮膚科学会大阪地方会の論文