Lupus Erythematosus Tumidus

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LE tumidus (LET) is a probably not so infrequent variety of CLE that is defined histopathologically by LE-type dermal inflammation, accumulation of mucin, and the absence of epidermal involvement (Kuhn et al. 2003). Clinically, it corresponds to erythematous discoid lesions most often of the face (zygomatic area) that are persistent and without a tendency for atrophy and scarring (Kuhn et al. 2000). Lymphocytic infiltration Jessner-Kanof is defined practically in the same way (Jessner and Kanof, 1953), and many authors argue that these conditions are identical (Ackerman 1997, Weber et al. 2001). Phototesting revealed a high incidence of photosensitivity with a distinct time course profile that was common to both conditions but different from polymorphous light eruption (Kuhn et al. 2001).

Plaque-type sarcoidosis may be clinically similar to LET because it features elevated, smooth-surfaced discoid lesions most often located on the face, scalp, upper trunk, and arms. In contrast to LET, they exhibit a brownish "apple-jelly" color under diascopy.

Plaque-like lesions of polymorphous light eruption (PLE) are both clinically and histopathologically similar to LET, and in both a history of photosensitivity is typically found. There are clinical differences, however: LET presents as a solitary or a few persistent nonitchy lesions, especially of the zygomatic area; polymorphous light eruption, in contrast, with multiple itchy lesions, particularly of the sun-exposed areas of the upper extremities, and decollete, which regress spontaneously within a few days. In the same line, PLE usually arises within 24 hours of sun exposure, whereas LET appears 2-5 days after phototesting (Weber et al. 2001). One should keep in mind, however, that photosensitivity of the PLE type is also found in SLE.

Granulomafacialeis another skin disorder that closely resembles LET. It presents as well-demarcated, elevated, asymptomatic, and persistent nodules and plaques, mostly in the faces of middle-aged patients. Granuloma faciale is usually a solitary lesion.

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