Also known as: lupus profundus

Clinical Features:

• Uncommon manifestation of systemic lupus erythematosus, or may occasionally be seen in the absence of the disease
• Possible relationship with subcutaneous lymphoma
• Presents with multiple indurated subcutaneous nodules, most commonly on the proximal extremities, but may occur elsewhere
• The overlying skin may show a variety of changes, including discoid lupus erythematosus, poikiloderma or ulceration.

Histologic Features:

• The overlying skin may or may not show features of systemic lupus erythematosus or discoid lupus erythematosus.
• Septal and lobular panniculitis with:
  • Lymphocytic inflammation, often with lymphoid aggregates and/or follicles, at the periphery of the fat lobules
  • Fequent plasma cells
  • Hyaline necrosis of the fat lobules, often with karyorrhectic debris and mucin deposition
  • Hyalinization of the adipose tissue, septa and blood vessels
  • Often lymphocytic vasculopathy or frank vasculitis with fibrin thrombi
  • Less characteristic changes that may sometimes be present include: thickening of the septa, septal granulomas and eosinophils.

Cases associated with this book:

Lupus panniculitis
Author: Stephen Lyle, M.D., Ph.D.

Conference: DermatopathologyConsultations.com Teaching Collection