Hyperpigmentation causes dermnet

Involvement of the dermoepidermal junction is focal or absent 3. Tumid LE can be difficult to distinguish from other dermal lymphocytic infiltrates on histopathologic criteria alone. Conditions to consider in the differential diagnosis include pseudolymphoma, polymorphous light eruption PMLEreticular erythematous mucinosis REMerythema migrans, and lymphocytic infiltrate of Jessner and Kanof.

Pseudolymphoma often shows germinal center formation and PMLE has marked papillary dermal edema, while erythema migrans is characterized by a tightly cuffed lymphoplasmacytic infiltrate with minimal interstitial involvement 8.

Historically, the serologic findings in tumid LE are unremarkable. Dekle, et al. Kuhn, et al. The diversity of these measurements elucidates the range of potential serologic findings in patients presenting with tumid LE alone or in combination with other forms of LE. The precise classification of tumid LE remains a topic of debate throughout the dermatology literature. In recent years, few studies have attempted to characterize the specific clinical and histopathologic features of tumid LE in order to define comprehensive criteria to distinguish it from other conditions and emphasize its value as a unique entity within the cutaneous LE spectrum.

While most published reports suggest that tumid LE is a form of chronic cutaneous LE, several propose that due to the lack of serology, epidermal change, and interface dermatitis on histopathologic evaluation, it may belong grouped with other lupus non-specific skin lesions.

The literature contains conflicting reports regarding the possibility of tumid LE occurring simultaneously with SLE or other forms of cutaneous LE 2 Although the association with systemic disease is low, there have been a number of documented reports of tumid LE coexisting with either DLE or SLE 1345. Additionally, we demonstrate the rare occurrence of a patient with tumid LE occurring below the waist.

Our patient, who had an earlier diagnosis of SLE with significant organ involvement, subsequently developed tumid LE.

She presented with annular dermal plaques on her thighs bilaterally. Although rare, this patient demonstrates the potential for tumid LE to occur in photoprotected sites like the upper thigh.

The presence of this rare variant of cutaneous lupus erythematosus amid the more common forms of SLE and DLE needs to be considered when managing patients with various forms of LE.

This awareness should enhance early diagnosis and emphasize that tumid LE can occur together with other forms of chronic cutaneous LE, as well as SLE. National Center for Biotechnology InformationU. J Clin Rheumatol. Author manuscript; available in PMC Mar 1. Author information Copyright and License information Disclaimer. Corresponding author: Victoria P. Copyright notice. The publisher's final edited version of this article is available at J Clin Rheumatol. See other articles in PMC that cite the published article.

Abstract Tumid lupus erythematosus is a rare variant of chronic cutaneous lupus erythematosus that is characterized clinically by smooth, nonscarring, pink to violaceous papules or plaques without evidence of surface change. Keywords: tumid lupus erythematosus, systemic lupus erythematosus, discoid lupus erythematosus, chronic cutaneous lupus erythematosus.

Introduction Lupus erythematosus LE is a multifaceted disease with a wide spectrum of manifestations, ranging from purely skin lesions in some cases of cutaneous lupus erythematosus CLE to the most severe form with multiple organ involvement in systemic lupus erythematosus SLE.

Open in a separate window. Figure 1. Figure 2. Figure 3. Figure 4. Figure 5. Figure 6. Perivascular lymphocytic infiltrate with increased interstitial dermal mucin. Comment Tumid lupus erythematosus was first reported by Erich Hoffman in at a meeting of the Berlin Dermatological Society.

Acknowledgments Funding Source: None. Footnotes Conflicts of Interest: None. References 1. Gougerot H, Burnier R. Archives of Dermatology. Arthritis and Rheumatism.

Hyperpigmentation causes dermnet

Tumid Lupus Erythematosus. The American Journal of Dermatopathology. Lupus Tumidus. J Am Acad Dermatol. Les traitements combinés obtiennent les meilleurs résultats, ils associent une photothérapie aux traitements médicaux ou aux transplantations mélanocytaires. Les microtraumatismes, en particulier les frottements et les pressions déclenchent ou aggravent le vitiligo qui se localise préférentiellement aux zones ou ceux ci sont importants.

Les mesures de prévention des microtraumatismes sont donc essentielles. La prévention des frottements est plus facile au visage, plus délicate voir impossible aux extrémités travailleurs manuels. Un maquillage correctif couvrant permet de masquer efficacement le vitiligo. Il existe une large palette de couleurs. Il faut tester les maquillages Covermark, couvrance avène, unifiance Vichy par exemple. Le stress et la dépression peuvent aggraver le vitiligo et avoir un impact négatif sur le traitement, leur prise en charge est donc hautement souhaitable.

Les taches au stades I et II sont susceptibles de répondre aux traitements médicaux alors que les lésions au stade III ne seraient pas améliorées par à ces traitements mais éventuellement grâce à une prise en charge traitement chirurgicale.

Les dermocorticoides et les inhibiteurs de la calcineurine représentent le traitement de première intension des vitiligo débutants. La surveillance de ces traitements doit-être rapprochée.

Les taches blanches doivent devenir légèrement rose — sans plus. On obtient en général un début de repigmentation après quatre à six semaines. La prise de psoralène par voie orale oblige à une protection oculaire pendant les vingt-quatre heures qui suivent la prise du médicament.

La PUVAthérapie est réalisée au cabinet du dermatologue sous sa surveillance. Les résultats commencent en général à se manifester après 12 à 18 séances soit un mois après le début du traitement. Les intensités lumineuses utilisées varient entre 2 et 5 joules en fonction du type de peau et de la réaction de celle ci. Toutes ces raisons font que les dermatologues préfèrent cette technique pour des photothérapies du corps entier.

En cas de vitiligo localisé, la tendance actuelle est de traiter seulement les zones touchées. Cette technique permet de délivrer le traitement uniquement aux zones atteintes. Gawkrodger, A. Ormerod, L. Shaw, I. Mauri-Sole, M. Whitton, M. Watts, A. Anstey, J. Ingham and K. Guideline for the diagnosis and management of vitiligo. British Association of Dermatologists. British Journal of Dermatologypp— Ortonne JP.

Traitement du vitiligo :. Représenter les patients auprès des instances médicales, ministérielles, européennes et internationales. Défendre les intérêts présents et futurs des malades, sensibiliser et soutenir la recherche. The vitiligo society : Vitiligo results in a loss of skin color. Vitiligo usually occurs in families, and may sometimes also involve diabetes, thyroid disorders, and some other conditions. National vitiligo foundation : A patient oriented site dedicated to information and treatment of vitiligo.

Orphanet Vitiligo : une information du site orphanet. American academy of dermatology — Vitiligo : a patient pamphlet from the American academy of dermatology. Clinical trials.