RESUMEN
A 71-year-old woman presented with pink to violaceous, flat-topped, polygonal papules on the volar wrists, extensor elbows, and bilateral lower legs of 3 years' duration. She also had erythematous, violaceous, infiltrated plaques with microvesiculation on the bilateral thighs of several months' duration. She reported pruritus, burning, and discomfort. Her medical history included type 2 diabetes mellitus, hypertension, and asthma with no history of skin rashes. Workup revealed lichen planus pemphigoides (LPP), a rare papulosquamous and vesiculobullous dermatosis that shares features of both lichen planus (LP) and bullous pemphigoid (BP). Despite multiple traditional therapies, her disease continued to progress, further developing mucosal disease. After a review of the literature on LP, BP, and LPP, it was noted that tumor necrosis factor α (TNF-α), along with other cytokines, plays a pivotal role in all 3 diseases. After several conventional systemic therapies failed, we treated our patient with ustekinumab with favorable results.
Asunto(s)
Fármacos Dermatológicos/uso terapéutico , Liquen Plano/tratamiento farmacológico , Penfigoide Ampolloso/tratamiento farmacológico , Ustekinumab/uso terapéutico , Anciano , Progresión de la Enfermedad , Femenino , Humanos , Liquen Plano/diagnóstico , Liquen Plano/patología , Penfigoide Ampolloso/diagnóstico , Penfigoide Ampolloso/patología , Resultado del TratamientoRESUMEN
Lupus mucinosis (LM) is a rare disorder found only in patients with systemic lupus erythematosus (SLE) or discoid lupus erythematosus (DLE). We describe a patient with lupus mucinotic nodules as the initial presenting sign of SLE. We further discuss other forms of cutaneous lupus and contrast them with our findings.