Necrotic erythema nodosum revealing systemic lupus: lupic’s panniculitis

Abstract

Lupic panniculitis is a rare clinical entity. We report a case revealed by erythema nodosum lesions. a 39-yearold man with no pathological history who consulted for a rash and poly arthralgia that had progressed for 6 months. The physical examination revealed painful nodules disseminated all over the body, associated with necrotic and cicatricial lesions. a cutaneous biopsy showed a predominantly lymphocytic, superficial and deep mononuclear infiltrate engulfing the hair follicles and infiltrating the hypodermis. The biological assessment showed: FaN> 1/1280 iu, anti native dNa ≥11ui and anti Sm ≥ 8 iu. The rest of the balance sheet was normal. The diagnosis of deep lupus Kaposi-irgang type is retained. prednisone treatment with hydroxy chloroquine markedly reduced the lesions after 8 weeks of treatment. This observation is particular in its mode of revelation, the occurrence in a man, the extent and the unusual location of the lesions. diffuse necrotic lesions without signs of systemic involvement should suggest the diagnosis of deep lupus.