LUPUS PANNICULITIS INVOLVING THE PAROTID/PERIPAROTID REGIONS AND BREAST; A RARE PRESENTATION

Authors

  • Shahbaz A. Janjua
  • Ian McColl
  • Jayakar Thomas

Abstract

Kaposi first described lupus erythematosus panniculitis, also known as lupus panniculitis and lupus profundus, in 1869, and Arnold established it as a subtype of lupus erythematosus in 1956.1  It is a chronic relapsing panniculitis that occurs in about 1 to 3% of patients with cutaneous lupus erythematosus and it is characterized by the development of deeply situated subcutaneous nodules and/or plaques with a predilection for the upper arms, face, shoulders and buttocks.2,3 Rarity of involvement of the lower extremities distinguishes this condition from other forms of panniculitis, particularly erythema nodosum4  Lupus panniculitis may occur as a separate entity or in association with systemic lupus erythematosus or discoid lupus erythematosus.5  As the serological abnormalities are rare, the diagnosis is based on the clinical and histological findings.  Antimalarials and corticosteroids are the mainstay of treatment but their real worth is still to be determined.4 We report a chronic case of lupus pannicultis in a middle-aged woman affecting her face including the left parotid/periparotid region, left upper arm and right breast.  Breast and parotid/periparotid areas are less commonly involved in lupus panniculitis.6,7 To the best our knowledge, only a few cases of lupus panniculitis involving the parotid/periparotid region have previously been reported in the literature

References

Nitta Y. Lupus erythematosus profundus associated with neonatal lupus erythematosus. Br J Dermatol 1997;136(1):112-4.

Tuffanelli DL. Lupus erythematosus panniculitis (profundus). Arch Dermatol. 1971;103(3):231-42.

Sanches NP, Peters MS, Winkleman RK. The histopathology of lupus erythematosus panniculitis. J Am Acad Dermatol 1981;5(6):673-80.

Martens PB, Moder KG, Ahmed I. Lupus panniculitis: clinical perspectives from a case series. J Rheumatol. 1999;26(1):68-72.

Peters MS, Su WP. Eosinophils in lupus panniculitis and morphea profunda. J Cutan Pathol 1991;18(3):189-92.

Cernea SS, Kihara SM, Sotto MN, Vilela MAC. Lupus mastitis. J Am Acad Dermatol 1993;29(2 Pt 2):343-6.

Jordan DR, McDonald H, Olberg B, McKim D, McKendry R. Orbital panniculitis as the initial manifestation of systemic lupus erythematosus. Ophthal Plast Reconstr Surg 1993;9(1):71-5.

White WL, Sherertz EF, Berg D, Clark RE. Periparotid lupus erythematosus panniculitis. Clinicopathologic correlation of two cases presenting as primary parotid disease. Arch Pathol Lab Med 1993;117(5):535-9.

Izumi AK, Takiguchi P. Lupus erythematosus panniculitis. Arch Dermatol 1983;119(1):61-4.

Requena L, Sanchez Yus E. Panniculitis. Panniculitis. Part II. Mostly lobular panniculitis. J Am Acad Dermatol 2001;45(3):325-61; quiz 362-4.

Winkleman RK. Panniculitis in connective tissue disease. Arch Dermatol 1983;119(4):336-44.

Patterson JW. Differential diagnosis of panniculitis. Adv Dermatol. 1991;6:309-29; discussion 330.

Chung HS, Hann SK. Lupus panniculitis treated by a combination therapy of hydroxychloroquine and quinacrine. J Dermatol 1997;24:569-72.

Burrows NP, Walport MJ, Hammond AH. Lupus erythematosus profundus with partial C4 deficiency responding to thalidomide. Br J Dermatol 1991;125(1):62-7.

Peters MS, Su WP. Lupus erythematosus panniculitis. Med Clin North Am. 1989;73(5):1113-26.