TY - JOUR
T1 - Two Unusual Cases of Discoid Lupus Erythematosus Associated With Xanthomatized Macrophages
AU - Weiss, Amy
AU - Kwon, Eun Ji
AU - Kreidel, Marit
AU - Mann, Ranon
AU - Cohen, Jason A.
AU - Hui, Yiang
AU - Jacobson, Mark I.
N1 - Publisher Copyright:
© 2019 Wolters Kluwer Health, Inc.
PY - 2020
Y1 - 2020
N2 - We present 2 patients with chronic discoid lupus erythematosus (LE) associated with xanthomatized macrophages on light microscopic findings. Skin biopsies revealed hyperkeratotic and atrophic epidermis, vacuolar degeneration of the dermal- epidermal junction, thickened basement membrane, follicular plugging, and perivascular and perifollicular lymphohistiocytic infiltrate. Notably, large collections of lipid-laden histiocytes were observed within the subjacent dermis. The patients denied history of intralesional steroid treatment. The patients did not demonstrate any clinical or laboratory signs of hyperlipidemia, cholestasis, and diabetes mellitus and insipidus. Accumulation of lipid-laden foam cells in cutaneous LE is a rare phenomenon that has been reported in discoid LE and lupus panniculitis, each only once in the literature. It has also been described within lesions of various other dermatoses in patients without lipid, hepatic, or endocrine abnormalities. Its mechanism remains unclear, but it has been hypothesized that intracellular lipids released from degenerating cells contribute to lipidization of mononuclear scavengers. Xanthomatous infiltration in cutaneous LE is an unusual feature, and its presence may not necessarily signify an underlying metabolic disorder.
AB - We present 2 patients with chronic discoid lupus erythematosus (LE) associated with xanthomatized macrophages on light microscopic findings. Skin biopsies revealed hyperkeratotic and atrophic epidermis, vacuolar degeneration of the dermal- epidermal junction, thickened basement membrane, follicular plugging, and perivascular and perifollicular lymphohistiocytic infiltrate. Notably, large collections of lipid-laden histiocytes were observed within the subjacent dermis. The patients denied history of intralesional steroid treatment. The patients did not demonstrate any clinical or laboratory signs of hyperlipidemia, cholestasis, and diabetes mellitus and insipidus. Accumulation of lipid-laden foam cells in cutaneous LE is a rare phenomenon that has been reported in discoid LE and lupus panniculitis, each only once in the literature. It has also been described within lesions of various other dermatoses in patients without lipid, hepatic, or endocrine abnormalities. Its mechanism remains unclear, but it has been hypothesized that intracellular lipids released from degenerating cells contribute to lipidization of mononuclear scavengers. Xanthomatous infiltration in cutaneous LE is an unusual feature, and its presence may not necessarily signify an underlying metabolic disorder.
KW - Discoid lupus erythematosus
KW - Lipid-laden histiocytes
KW - Xanthomatous infiltrate
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U2 - 10.1097/DAD.0000000000001510
DO - 10.1097/DAD.0000000000001510
M3 - Article
C2 - 31464721
AN - SCOPUS:85078684556
SN - 0193-1091
VL - 42
SP - 129
EP - 132
JO - American Journal of Dermatopathology
JF - American Journal of Dermatopathology
IS - 2
ER -