Papulonodular mucinosis in a patient with systemic lupus erythematosus and antiphospholipid syndrome

J Drugs Dermatol. 2014 May;13(5):621-3.

Abstract

The skin is one of the target organs most commonly affected in lupus erythematosus (LE) and a wide range of cutaneous changes have been described in LE patients. Papulonodular mucinosis (PNM) in particular is an uncommon cutaneous manifestation of LE. We discuss the case of a 26-year-old Senegalese woman with systemic LE and antiphospholipid syndrome (APS) who presented with pruritic papules on her back and extremities that appeared when she was on vacation in Africa and non-compliant with medications. Histopathologic examination was consistent with PNM. The patient was treated with mycophenolate mofetil and hydroxychloroquine, with subjective relief in pruritis at 6-week follow-up. To our knowledge, this is the first case of PNM presenting in a patient with both SLE and APS. Whether APS contributes to the pathogenesis of PNM is currently unknown.

Publication types

  • Case Reports

MeSH terms

  • Adult
  • Antiphospholipid Syndrome / complications*
  • Antiphospholipid Syndrome / drug therapy
  • Female
  • Follow-Up Studies
  • Humans
  • Hydroxychloroquine / therapeutic use
  • Immunosuppressive Agents / therapeutic use
  • Lupus Erythematosus, Systemic / complications*
  • Lupus Erythematosus, Systemic / drug therapy
  • Mucinoses / drug therapy
  • Mucinoses / etiology*
  • Mucinoses / pathology
  • Mycophenolic Acid / analogs & derivatives
  • Mycophenolic Acid / therapeutic use

Substances

  • Immunosuppressive Agents
  • Hydroxychloroquine
  • Mycophenolic Acid