안면부에 발생하는 만성피부홍반루푸스의 임상 및 조직소견에 대한 고찰

Abstract

Background: Cutaneous lupus erythematosus (CLE) on the face has various manifestations, and unusual variants mimicking rosacea or acneiform eruptions have been described in the literature. Objective: This study aimed to analyze the clinical and pathological data of Korean patients with chronic CLE (CCLE) and compare specific subtypes. Methods: In this single-center retrospective study, the medical records of 48 patients with CCLE on the face between 2006 and 2022 were reviewed. Results: Most patients were diagnosed with discoid lupus erythematosus (83.3%), followed by rosacea-like CLE (14.6%), and comedogenic lupus (2.1%). The discoid subtype typically presents as a disk-shaped lesion with a sharp demarcation, dyspigmentation, atrophic scarring, and follicular hyperkeratosis. The rosacea-like variant exhibited diffuse erythema, mainly on the central face. One case of comedogenic lupus was defined as an acneiform eruption of erythematous papules and pustules. Histopathological findings showed that the rosacea-like subtype showed mild or focal interface dermatitis and more superficial perivascular and periappendageal lymphocytic infiltration than the discoid variant. Patients with comedogenic lupus exhibit focal interface dermatitis, distinct follicular plugging, and deep dermal lymphocytic infiltration. The rosacea-like variant had greater involvement of the central cheeks (p= 0.002) and shorter treatment duration (p=0.009) than the discoid subtype. Conclusion: This study emphasizes the need for a comprehensive analysis of clinical, histopathological, and laboratory findings in patients with CCLE on the face, as rare variants exhibit distinct characteristics, leading to delayed diagnosis and treatment. (Korean J Dermatol 2024;62(9):493∼502)