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= a rare subset of chronic cutaneous LE (CCLE)
clinical:
| • | erythematous , succulent, urticaria-like, non-scarring plaques with a smooth surface in sun-exposed areas (the 5 L ddx) |
| • | highlights: male predominance, negative lesional DIF, and virtual absence of associated SLE disease activity |
| • | ddx: Jessner’s lymphocytic infiltrate, REM, pseudolymphoma |
| • | PMLE – tumid LE shows a more delayed reaction after sun exposure and healing of lesions takes longer |
| • | REM – REM is mostly on chest and upper back (but difficult, as REM can be induced by sun and it responds to antimalarials) |
| • | treatment: rapid and effective treatment with antimalarials (90%) |
histology:
| • | perivascular and periadnexal lymphocytic infiltrate |
| • | a distinct subepidermal edema |
| • | moderate to copious interstitial mucin deposition (detected with colloidal iron staining) |
| • | no epidermal involvement or alteration of the dermoepidermal junction (essentially only the dermal histologic changes of LE) |
| • | analogy: LE --> tumid LE --> lupus profundus (EM --> Sweet’s syndrome --> e. nodosum) |
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