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Degos-Like Lesions Associated with Systemic Lupus Erythematosus

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초록

Degos disease, also referred to as malignant atrophic papulosis, was first described in 1941 by Köhlmeier and was independently described by Degos in 1942. Degos disease is characterized by diffuse, papular skin eruptions with porcelain- white centers and slightly raised erythematous telangiectatic rims associated with bowel infarction. Although the etiology of Degos disease is unknown, autoimmune diseases, coagulation disorders, and vasculitis have all been considered as underlying pathogenic mechanisms. Approximately 15% of Degos disease have a benign course limited to the skin and no history of gastrointestinal or central nervous system (CNS) involvement. A 29-year-old female with history of systemic lupus erythematosus (SLE) presented with a 2-year history of asymptomatic lesions on the dorsum of all fingers and both knees. The patient had only skin lesions and no gastrointestinal or CNS vasculitis symptoms. Her skin lesions were umbilicated, atrophic porcelain-white lesions with a rim of erythema. On the basis of clinical, histologic, and laboratory findings, a diagnosis of Degos-like lesions associated with SLE was made. The patient had been treated for SLE for 7 years. Her treatment regimen was maintained over a 2 month follow-up period, and the skin lesions improved slightly with no development of new lesions.

Abstract

Degos disease, also referred to as malignant atrophic papulosis, was first described in 1941 by Köhlmeier and was independently described by Degos in 1942. Degos disease is characterized by diffuse, papular skin eruptions with porcelain- white centers and slightly raised erythematous telangiectatic rims associated with bowel infarction. Although the etiology of Degos disease is unknown, autoimmune diseases, coagulation disorders, and vasculitis have all been considered as underlying pathogenic mechanisms. Approximately 15% of Degos disease have a benign course limited to the skin and no history of gastrointestinal or central nervous system (CNS) involvement. A 29-year-old female with history of systemic lupus erythematosus (SLE) presented with a 2-year history of asymptomatic lesions on the dorsum of all fingers and both knees. The patient had only skin lesions and no gastrointestinal or CNS vasculitis symptoms. Her skin lesions were umbilicated, atrophic porcelain-white lesions with a rim of erythema. On the basis of clinical, histologic, and laboratory findings, a diagnosis of Degos-like lesions associated with SLE was made. The patient had been treated for SLE for 7 years. Her treatment regimen was maintained over a 2 month follow-up period, and the skin lesions improved slightly with no development of new lesions.

참고문헌 (14)

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  8. Ball E, "Degos' disease: a distinctive pattern of disease, chiefly of lupus erythematosus, and not a specific disease per se", Am J Dermatopathol, 25, pp.308~320 (2003)
  9. Cardinali C, "The spectrum of cutaneous manifestations in lupus erythematosus--the Italian experience", Lupus, 9, pp.417~423 (2000)
  10. Ramos-Casals M, "Vasculitis in systemic lupus erythematosus:prevalence and clinical characteristics in 670patients", Medicine (Baltimore), 85, pp.95~104 (2006)
  11. Anker JP, "The dermoscopic variability of Degos disease at different stages of progression", Dermatol Pract Concept, 4, pp.59~61 (2014)
  12. Harvell JD, "Benign cutaneous Degos' disease: a case report with emphasis on histopathology as papules chronologically evolve", Am J Dermatopathol, 23, pp.116~123 (2001)
  13. 김영지, "Degos Disease Associated with Behçet’s Disease", Annals of Dermatology, 27(2), pp.235~236 (2015), 대한피부과학회
  14. Melnik B, "Malignant atrophic papulosis (Köhlmeier-Degos disease). Failure to respond to interferon alpha-2a, pentoxifylline and aspirin", Hautarzt, 53, pp.618~621 (2002)

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