Case Number : Case 371 Posted By: Guest

Marcela Escanamé - Medical University of Graz (Austria) Wrote:

Polymorphous Light Eruption (superficial and deep infiltrate lymphocytes, no mucin, edema in superficial dermis, no thick BM) The clinical history with vesicles on face is against to Lupus.

Submitted on 12/11/2011 12:05
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Phillip McKee - Overseas Consultations (Cave Creek, Arizona, USA) Wrote:

Again this case has proven challenging. The clinical history is very helpful as it does not suggest lupus. There is no real interface change. What we are seeing is massive papillary dermal edema with a superficial and deep lymphocytic infiltrate. The features fit best with polymorphous light eruption. Interestingly, most cases of tumid lupus that I have seen have had minimal or no epidermal/interface change. The main histology has been one of massive mucin deposition mostly in the deeper dermis.

Submitted on 10/11/2011 12:36
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Rodrigo Restrepo - UPB/CES (Mdlln/Col) Wrote:

Cutaneous lupus erythematosus

Submitted on 10/11/2011 07:40
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Hazem Hamed - Department of Histopathology, Imperial College (London) Wrote:

I would go for Polymorphous light eruption.

Submitted on 10/11/2011 06:49
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Peter Karolyi - () Wrote:

My opinion is that it is Polymorphous light eruption.In Tumid LE one detects a lot of mucin between collagen bundles, but I could not see here. Another (not so possible) diff. dg can be Lymphocytic infiltrate of the skin, Jessner, but it is a dg of exclusion only. REM, but no increased mucin + not a typical localisation.

Submitted on 10/11/2011 06:47
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Marcela Saeb Lima - INCMNSZ (Mexico City) Wrote:

Cutaneous lupus erythematosus

Submitted on 10/11/2011 06:19
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Sasi Attili - (UK) Wrote:

Superficial and deep perivascular lyymphocytic infiltrate. Not convinced of a true vasculitis but there are a few superficial thrombosed capillaries with some extravasation of RBC associated with papillary dermal oedema going into incipient vesiculation. The lymphocytes are fairly monomorphous. Given the clinical setting Polymorphic light eruption is my diagnosis but depends on history. Tumid lupus is another differential but the papules and vesicles are against this.

Submitted on 10/11/2011 06:07
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Mona Abdel Halim - Dermatology Dept. Cairo Univ. (Egypt) Wrote:

Superficial and deep perivascular and periadnexal infiltrate composed predominantly of lymphocytes, sub epidermal edema and extravasated RBC's, tight cuffing of lymphocytes around blood vessels. Polymorphous light eruption.

Submitted on 10/11/2011 06:04
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I. Abdul-kadir - SJUH (Leeds, UK) Wrote:

My first impression was lupus. Since there's no interface reaction, tumid lupus erythematosus?

Submitted on 10/11/2011 06:02