Pretty in Pink, but is it? What do you think Dr Arti Bakshi's Case is?

Cheers, Geoff

DermpathPRO Projects

Tumid LE. DD Jessner's.

Lupus diagnosis is always a challenge. But I agree with Hazem.   

Tumid LE.

Tunis lupus

Yes, LE tumidus

Agree with the impression of tumid lupus/jessner. I thought that the clinical picture was funny though: isolated lesion in a non photoexposed area in an adult older than 45. I would still perform immunos: cd20, 3, 4, 8 and 123. The clinical picture and histology looks rather benign but I would not like to miss a lymphoma

Lupus erythematosus tumidus

Superficial and deep perivascular and periappendageal lymphocytic infiltrate accompanied by prominent dermal mucin deposition. Epidermal changes are lacking, or there is only slight epidermal atrophy. Agree with lupus erythematosus tumidus.

Interestingly enough the intermittent firmness of the lesion.

lupus tumidus

Yes, this is a case of tumid lupus erythematosus.

Raul, we did do some immunos and it was a T cell rich infiltrate with a mixed CD4 and CD8 population. Have asked Geoff to put an image of CD123, which shows nice clusters of palsmacytoid dendritic cells. 

For the newbies, tumid lupus erythematosus is a distinct subtype of chronic lupus erythematosus which differs clinically from other forms of lupus in the absence of surface epidermal changes, lack of scarring on resolution and low risk of association with systemic lupus (and often negative serology).  Here is a link to a nice review article:

http://www.actasdermo.org/en/lupus-erythematosus-tumidus-a-clinical/articulo/S1578219011001053/

Great to see some new names in the contributors...welcome to all!

Thank you Arti for this interesting case and big welcome to the new participants