Interstitial granulomatous dermatitis: a misdiagnosed cutaneous form of systemic lupus erythematosus?

Clin Exp Dermatol. 2008 Nov;33(6):712-4. doi: 10.1111/j.1365-2230.2008.02774.x. Epub 2008 Aug 2.

Abstract

Interstitial granulomatous dermatitis (IGD) is a recently described, rare dermatological entity. The clinical features are diverse and the precise aetiology is unknown. We present a rare and atypical case of IGD in a patient with systemic lupus erythematosus (SLE). A 26-year-old woman had been diagnosed with SLE when she was 15 years old. The diagnosis was based on cutaneous, articular, pulmonary, haematological and immunological features. The patient presented with a cutaneous diffuse macular eruption on the limbs, appearing in a cockade (rosette) pattern with a violaceous centre and erythematous surround. The face and trunk were spared. The cutaneous histological features led us to consider a diagnosis of IGD. The lesions disappeared after 15 days of systemic steroid therapy. This case is a new clinical form of IGD with an atypical location and clinical presentation. IGD has usually been associated with drug-related adverse reactions and autoimmune diseases. Reports in the literature of IGD in patients with SLE are rare.

Publication types

  • Case Reports

MeSH terms

  • Adult
  • Azathioprine / therapeutic use
  • Dermatitis / complications*
  • Dermatitis / diagnosis
  • Dermatitis / drug therapy
  • Drug Therapy, Combination
  • Female
  • Glucocorticoids / therapeutic use
  • Humans
  • Lupus Erythematosus, Systemic / complications*
  • Lupus Erythematosus, Systemic / diagnosis
  • Lupus Erythematosus, Systemic / drug therapy
  • Prednisolone / therapeutic use
  • Skin / pathology*
  • Warfarin / therapeutic use

Substances

  • Glucocorticoids
  • Warfarin
  • Prednisolone
  • Azathioprine