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Drug‐Induced Follicular Lupus‐Like Eruption
Author(s) -
Galan A.,
Elpern D.J.,
Byers H.R.
Publication year - 2005
Publication title -
journal of cutaneous pathology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.597
H-Index - 75
eISSN - 1600-0560
pISSN - 0303-6987
DOI - 10.1111/j.0303-6987.2005.320ca.x
Subject(s) - medicine , pathology , dermatology , discoid lupus erythematosus , lupus erythematosus , erythema , anti nuclear antibody , hydrochlorothiazide , systemic lupus erythematosus , antibody , autoantibody , immunology , disease , blood pressure
A 51‐year‐old female presented with agminate flesh‐colored, slightly hyperkeratotic papules, 3–5 mm in diameter, on her upper back and to a lesser extent on the upper chest, neck and forehead. The papules were centered around the hair follicles and several showed mild perifollicular erythema. Clinical impression was keratosis pilaris with an unusual distribution or follicular mucinosis. Medications included hydrochlorothiazide (HCTZ), begun several months previously, along with potassium supplements. Histologic findings revealed mild interface dermatitis with rare individually necrotic keratinocytes and mild pigment incontinence, a superficial and mid perivascular and periappendageal lymphocytic infiltrate with marked dermal mucin deposition and extravasated erythrocytes. No definitive basement membrane thickening was present. Laboratory investigation revealed antinuclear antibodies at 1:640; anti‐double stranded DNA and anti‐histone antibody titers were normal. Following discontinuance of HCTZ and addition of topical steroids, her eruption slowly resolved. Taken together, these findings are those of a new cutaneous manifestation of a drug‐induced lupus‐like eruption. We have named it drug‐induced follicular lupus‐like eruption to reflect the drug‐induced counterpart of the newly described follicular lupus erythematosus.