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Refractory palmo-plantar discoid lupus erythematosus successfully treated with mycophenolate mofetil: Unusual localization and literature review.
Dermatol Ther. 2021 Jan 06 [Online ahead of print]DT

Abstract

Palmo-plantar lesions in discoid lupus erythematosus (DLE) can be considered a very distinct rarity, generally refractory to conventional treatments. We present a 47-year-old African female patient with a 6-month clinical history of palm and soles erosions. Clinical examination revealed painful multiple, well defined, erosions with an erythematous and scaly central area and peripherical post-inflammatory hyperchromic border bilaterally distributed on the palmo-plantar surfaces. Pterygium inversum unguis involved all nails of both hands. Histological analysis and direct immunofluorescence study confirmed palmo-plantar DLE. Therapy with mycophenolate mofetil (MMF) was initiated with a progressive clearing of palmo-plantar lesions and a drastic reduction of pain. Therapy was well tolerated, neither side effects nor altered laboratory investigations were observed. Our case and literature review confirm that MMF may be an effective approach for the management of refractory palmo-plantar DLE with a safer profile than Azathioprine regarding adverse effects and cutaneous malignancies risk.

Authors+Show Affiliations

Department of Experimental, Diagnostic and Specialty Medicine, Division of Dermatology, S. Orsola-Malpighi Hospital, University of Bologna, Bologna, Italy.Department of Medical Sciences, Section of Dermatology, University of Turin, Turin, Italy.Department of Experimental, Diagnostic and Specialty Medicine, Division of Dermatology, S. Orsola-Malpighi Hospital, University of Bologna, Bologna, Italy.Department of Experimental, Diagnostic and Specialty Medicine, Division of Dermatology, S. Orsola-Malpighi Hospital, University of Bologna, Bologna, Italy.Department of Experimental, Diagnostic and Specialty Medicine, Division of Dermatology, S. Orsola-Malpighi Hospital, University of Bologna, Bologna, Italy.Department of Experimental, Diagnostic and Specialty Medicine, Division of Dermatology, S. Orsola-Malpighi Hospital, University of Bologna, Bologna, Italy.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

33404096

Citation

Bardazzi, Federico, et al. "Refractory Palmo-plantar Discoid Lupus Erythematosus Successfully Treated With Mycophenolate Mofetil: Unusual Localization and Literature Review." Dermatologic Therapy, 2021, pp. e14743.
Bardazzi F, Gallo G, Loi C, et al. Refractory palmo-plantar discoid lupus erythematosus successfully treated with mycophenolate mofetil: Unusual localization and literature review. Dermatol Ther. 2021.
Bardazzi, F., Gallo, G., Loi, C., Misciali, C., Patrizi, A., & Filippini, A. (2021). Refractory palmo-plantar discoid lupus erythematosus successfully treated with mycophenolate mofetil: Unusual localization and literature review. Dermatologic Therapy, e14743. https://doi.org/10.1111/dth.14743
Bardazzi F, et al. Refractory Palmo-plantar Discoid Lupus Erythematosus Successfully Treated With Mycophenolate Mofetil: Unusual Localization and Literature Review. Dermatol Ther. 2021 Jan 6;e14743. PubMed PMID: 33404096.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Refractory palmo-plantar discoid lupus erythematosus successfully treated with mycophenolate mofetil: Unusual localization and literature review. AU - Bardazzi,Federico, AU - Gallo,Giuseppe, AU - Loi,Camilla, AU - Misciali,Cosimo, AU - Patrizi,Annalisa, AU - Filippini,Andrea, Y1 - 2021/01/06/ PY - 2020/11/08/received PY - 2020/12/06/revised PY - 2020/12/30/accepted PY - 2021/1/7/pubmed PY - 2021/1/7/medline PY - 2021/1/6/entrez KW - Mycophenolate Mofetil KW - Palmo-plantar discoid lupus Erythematosus KW - Pterygium inversum unguis KW - azathioprine KW - discoid lupus Erythematosus KW - drug response SP - e14743 EP - e14743 JF - Dermatologic therapy JO - Dermatol Ther N2 - Palmo-plantar lesions in discoid lupus erythematosus (DLE) can be considered a very distinct rarity, generally refractory to conventional treatments. We present a 47-year-old African female patient with a 6-month clinical history of palm and soles erosions. Clinical examination revealed painful multiple, well defined, erosions with an erythematous and scaly central area and peripherical post-inflammatory hyperchromic border bilaterally distributed on the palmo-plantar surfaces. Pterygium inversum unguis involved all nails of both hands. Histological analysis and direct immunofluorescence study confirmed palmo-plantar DLE. Therapy with mycophenolate mofetil (MMF) was initiated with a progressive clearing of palmo-plantar lesions and a drastic reduction of pain. Therapy was well tolerated, neither side effects nor altered laboratory investigations were observed. Our case and literature review confirm that MMF may be an effective approach for the management of refractory palmo-plantar DLE with a safer profile than Azathioprine regarding adverse effects and cutaneous malignancies risk. SN - 1529-8019 UR - https://www.unboundmedicine.com/medline/citation/33404096/Refractory_palmo-plantar_discoid_lupus_erythematosus_successfully_treated_with_mycophenolate_mofetil:_Unusual_localization_and_literature_review L2 - https://doi.org/10.1111/dth.14743 DB - PRIME DP - Unbound Medicine ER -
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