Publications by authors named "Andrew G Franks"

60 Publications

A Comparison of 2019 EULAR/ACR SLE Classification Criteria with Two Sets of Earlier SLE Classification Criteria.

Arthritis Care Res (Hoboken) 2020 May 20. Epub 2020 May 20.

Division of Biostatistics and Bioinformatics, Department of Epidemiology and Public Health, University of Maryland School of Medicine, Baltimore, Maryland, USA.

Objective: The Systemic Lupus International Collaborating Clinics (SLICC) 2012 SLE classification criteria and the revised American College of Rheumatology (ACR) 1997 criteria are list-based, counting each SLE manifestation equally. We derived a classification rule based on giving variable weights to the SLICC criteria, and compared its performance to the revised ACR 1997, unweighted SLICC 2012 and the newly reported European League Against Rheumatism (EULAR)/ACR 2019 criteria.

Methods: The physician-rated patient scenarios used to develop the SLICC 2012 classification criteria were re-employed to devise a new weighted classification rule using multiple linear regression. The performance of the rule was evaluated on an independent set of expert-diagnosed patient scenarios and compared to the performance of the previously reported classification rules.

Results: Weighted SLICC criteria and the EULAR/ACR 2019 criteria had less sensitivity but better specificity compared to the list-based revised ACR 1997 and SLICC 2012 classification criteria. There were no statistically significant differences between any pair of rules with respect to overall agreement with the physician diagnosis.

Conclusion: The two new weighted classification rules did not perform better than the existing list-based rules in terms of overall agreement on a dataset originally generated to assess the SLICC criteria. Given the added complexity of summing weights, researchers may prefer the unweighted SLICC criteria. However, the performance of a classification rule will always depend on the populations from which the cases and non-cases are derived, and whether the goal is to prioritize sensitivity or specificity.
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http://dx.doi.org/10.1002/acr.24263DOI Listing
May 2020

Case report of discoid lupus erythematosus in association with electronic cigarette use.

JAAD Case Rep 2019 Dec 13;5(12):1030-1032. Epub 2019 Nov 13.

The Ronald O. Perelman Department of Dermatology, New York University School of Medicine, New York, New York.

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http://dx.doi.org/10.1016/j.jdcr.2019.05.027DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6864197PMC
December 2019

Eosinophilic Fasciitis With Concomitant Morphea Profunda Treated With Intravenous Immunoglobulin.

J Clin Rheumatol 2019 Oct 29. Epub 2019 Oct 29.

The Ronald O. Perelman Department of Dermatology New York University School of Medicine New York, NY

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http://dx.doi.org/10.1097/RHU.0000000000001158DOI Listing
October 2019

Morphea in a patient undergoing treatment with ustekinumab.

JAAD Case Rep 2019 Jul 26;5(7):590-592. Epub 2019 Jun 26.

The Ronald O. Perelman Department of Dermatology, New York University School of Medicine, New York, New York.

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http://dx.doi.org/10.1016/j.jdcr.2019.05.008DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6610639PMC
July 2019

A patient with POEMS syndrome responding to modified CyBorD chemotherapy as a bridge to autologous stem cell transplantation.

JAAD Case Rep 2019 Mar 12;5(3):228-230. Epub 2019 Feb 12.

The Ronald O. Perelman Department of Dermatology, New York University School of Medicine, New York, New York.

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http://dx.doi.org/10.1016/j.jdcr.2019.01.003DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6374952PMC
March 2019

Protean Neurologic Manifestations of Two Rare Dermatologic Disorders: Sweet Disease and Localized Craniofacial Scleroderma.

Curr Neurol Neurosci Rep 2019 02 12;19(3):11. Epub 2019 Feb 12.

NYU Multiple Sclerosis Comprehensive Care Center, Department of Neurology, New York University School of Medicine, New York, NY, USA.

Purpose Of Review: To describe diverse neurologic and neuroradiologic presentations of two rare, immunologically mediated skin conditions: Sweet disease and localized scleroderma (morphea).

Recent Findings: Core syndromes of neuro-Sweet disease (NSD) are steroid responsiveness, recurrent meningitis, and encephalitis. Focal neurologic, neuro-vascular, and neuro-ophthalmologic syndromes have been reported recently in NSD. A variety of steroid-sparing treatments and biologics have been used for relapsing NSD. Localized craniofacial scleroderma is associated with seizures, headaches, and, less commonly, focal deficits and cognitive decline. Immunosuppressive therapy may be required in patients with disease progression; some refractory cases have responded to IL-6 inhibition. Our review provides an up-to-date reference for neurologists faced with a patient with a history or skin findings consistent with Sweet disease or localized scleroderma. We hope that it will stimulate collaborative studies aimed at unraveling the pathogenesis of these disorders, better characterization of their neurologic manifestations, and discovery of optimal therapeutic solutions.
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http://dx.doi.org/10.1007/s11910-019-0929-8DOI Listing
February 2019

Primary anetoderma with undifferentiated connective tissue disease.

Dermatol Online J 2017 Dec 15;23(12). Epub 2017 Dec 15.

New York University Health, New York.

Anetoderma is a rare benign elastolytic disorder that is characterized by focal loss of elastin fibers on histopathology and is often recalcitrant to treatment. We present a case of a patient with a 20-year history of pruritic and painful hyperpigmented atrophic papules clustered on the neck, axillae, inframammary folds, and right medial thigh. Although the histopathologyof her axillary lesions was consistent with anetoderma, her clinical presentation is unusual given the extent of involvement, reported pain and pruritus, and sharp demarcation of the distribution. The diagnosticuncertainty of this case led to added difficulty in management of a disease that is already notoriously difficult to treat and may significantly impact patient's quality of life.
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December 2017

A systematic review and meta-analysis of the effects of topical nitrates in the treatment of primary and secondary Raynaud's phenomenon.

J Am Acad Dermatol 2018 Jun 31;78(6):1110-1118.e3. Epub 2018 Mar 31.

Skin Lupus and Autoimmune Connective Tissue Section, The Ronald O. Perelman Department of Dermatology, New York University School of Medicine, New York, New York; Division of Rheumatology, The Department of Internal Medicine, New York University School of Medicine, New York, New York. Electronic address:

Background: Multiple placebo-controlled trials have assessed locally applied topical nitrate preparations in treating Raynaud's phenomenon (RP).

Objectives: The objective of this meta-analysis was to assess the effects of local topical nitrates in primary and secondary RP with respect to a combined end point integrating parameters of digital blood flow and clinical severity.

Methods: A systematic review was performed using MEDLINE, Embase, and the Cochrane library. Only trials comparing locally applied topical nitrates with placebo comparators were included. Studies were appraised for bias by 2 independent reviewers.

Results: A total of 7 placebo-controlled trials including 346 patients were used in the meta-analysis; 4 trials used nitroglycerin ointments, 2 used the nitroglycerin gel vehicle MQX-503, and 1 used compounded nitrite. The meta-analysis results supported a moderate-to-large treatment effect in RP (standardized mean difference [SMD] = 0.70; 95% CI, 0.35-1.05; P < .0001). Subgroup analyses showed a large treatment effect in secondary RP (SMD = 0.95; 95% CI, 0.25-1.65; P = .008) and moderate effect in primary RP (SMD = 0.45; 95% CI, 0.05-0.85; P = .03).

Limitations: Limitations include the inclusion of multiple topical nitrate preparations and integration of different outcomes assessments.

Conclusion: Local topical nitrates have significant efficacy in the treatment of both primary and secondary RP.
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http://dx.doi.org/10.1016/j.jaad.2018.01.043DOI Listing
June 2018

The Frisbee maneuver: A novel method to abort acute attacks of the Raynaud phenomenon.

J Am Acad Dermatol 2018 03 7;78(3):e61. Epub 2017 Oct 7.

Ronald O. Perelman Department of Dermatology, New York University School of Medicine, New York, New York. Electronic address:

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http://dx.doi.org/10.1016/j.jaad.2017.09.066DOI Listing
March 2018

Wood's lamp as a tool in the evaluation of morphea.

J Am Acad Dermatol 2018 02 7;78(2):e33-e34. Epub 2017 Oct 7.

Ronald O. Perelman Department of Dermatology, New York University School of Medicine, New York, New York. Electronic address:

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http://dx.doi.org/10.1016/j.jaad.2017.10.003DOI Listing
February 2018

Novel use of apremilast for adjunctive treatment of recalcitrant pyoderma gangrenosum.

JAAD Case Rep 2017 May 14;3(3):228-229. Epub 2017 Apr 14.

Ronald O. Perelman Department of Dermatology, New York University School of Medicine, New York, New York.

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http://dx.doi.org/10.1016/j.jdcr.2017.02.019DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5394202PMC
May 2017

Topical drug-induced subacute cutaneous lupus erythematosus isolated to the hands.

Lupus Sci Med 2017 13;4(1):e000207. Epub 2017 Mar 13.

The Ronald O. Perelman Department of Dermatology, New York University School of Medicine, New York, New York, USA; Division of Rheumatology, Department of Medicine, New York University School of Medicine, New York, New York, USA.

Subacute cutaneous lupus erythematosus (SCLE) is a well-defined subtype of lupus erythematosus, characterised by photosensitivity, annular and/or psoriasiform lesions, variable systemic involvement and presence of circulating SSA/anti-Ro antibodies. SCLE may be idiopathic or drug-induced. Both the idiopathic and drug-induced forms of SCLE are analogous in their clinical, serological and histological features. Drug-induced SCLE has been reported with various oral agents, but to our knowledge this is the first reported case due to a topical medication. A 34-year-old female foot masseuse presented with a 2-month history of scaly, erythematous lesions isolated to the dorsal hands and interdigital spaces. She had used topical terbinafine, a topical antifungal cream, to her clients' feet for a number of years. ANA and anti-SSA/Ro antibodies were positive. Physical examination, serology and histopathology were consistent with SCLE. We propose that our patient's unique presentation of SCLE may be explained by a prolonged occupational exposure to topical terbinafine as a foot masseuse. While oral terbinafine is a drug known to cause drug-induced SCLE, to our knowledge, this is the first topically induced form of the disease.
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http://dx.doi.org/10.1136/lupus-2017-000207DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5353283PMC
March 2017

Anti-MDA5 Antibody Dermatomyositis Overlap with Systemic Lupus Erythematosus: A Case Report and Review of the Literature.

Open Rheumatol J 2016 30;10:122-128. Epub 2016 Nov 30.

Ronald O. Perelman Department of Dermatology, New York University School of Medicine, New York, USA; Department of Medicine, Division of Rheumatology, New York University School of Medicine, New York, USA.

Background: Dermatomyositis (DM) is an autoimmune connective tissue disease that primarily targets the muscle, skin, and lungs. Many patients have autoantibodies that correspond to distinct clinical phenotypes. Melanoma differentiation-associated gene 5 (anti-MDA5) antibody, a specific antibody that targets the melanoma differentiation-associated gene 5 (MDA5), has been reported in DM cases and is significant for a distinct cutaneous presentation and rapidly progressive interstitial lung disease.

Objective: Herein, we describe a patient with DM with a positive anti-MDA5 antibody and characteristic clinical phenotype, who subsequently developed coexisting systemic lupus erythematosus (SLE). A diagnosis of SLE was supported by his clinical phenotype, positive serologies, hypocomplementemia, and progression to glomerulonephritis and lupus cerebritis, features of which fulfilled the American College of Rheumatology criteria for SLE.

Conclusion: DM is known to overlap with other autoimmune diseases, including SLE, and coexistence can lead to a wide variety of clinical presentations. SLE overlapping with anti-MDA5 positive DM may present with distinct clinical features.
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http://dx.doi.org/10.2174/1874312901610010122DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5204063PMC
November 2016

An erythema gyratum repens variant of bullous lupus erythematosus.

JAAD Case Rep 2016 Mar 3;2(2):111-3. Epub 2016 Mar 3.

Ronald O. Perelman Department of Dermatology, New York University Langone Medical Center, New York, New York.

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http://dx.doi.org/10.1016/j.jdcr.2016.01.009DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4810286PMC
March 2016

Characteristics and treatment of adult-onset linear morphea: A retrospective cohort study of 61 patients at 3 tertiary care centers.

J Am Acad Dermatol 2016 Mar;74(3):577-9

The Ronald O. Perelman Department of Dermatology, New York University Langone Medical Center, New York. Electronic address:

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http://dx.doi.org/10.1016/j.jaad.2015.09.069DOI Listing
March 2016

Dermatomyositis, clinically presenting with cutaneous ulcers, with histopathologic evidence of perforating collagenosis.

Dermatol Online J 2016 Dec 15;22(12). Epub 2016 Dec 15.

Ronald O. Perelman Department of Dermatology, NYU School of Medicine, NYU Langone Medical Center.

Dermatomyositis is a systemic, autoimmune diseasewith a variety of clinical features that often includemyositis and characteristic cutaneous findings. Asubset of patients with dermatomyositis developcutaneous ulcers, often in the setting of vasculitis orvasculopathy. We present a case of dermatomyositiswith cutaneous ulcers that show perforatingcollagenosis on histopathologic examination.Acquired reactive perforating collagenosistypically occurs in the setting of diabetes mellitus,chronic renal failure, and other pruritic conditions,and this case represents a rare association withdermatomyositis, which may ultimately be helpful inelucidating the pathophysiology of this perforatingdisorder.
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December 2016

Lichen planus pigmentosus.

Dermatol Online J 2016 Dec 15;22(12). Epub 2016 Dec 15.

Ronald O. Perelman Department of Dermatology, NYU School of Medicine, NYU Langone Medical Center.

Lichen planus pigmentosus (LPP) is a type oflichenoid dermatitis with superficial dermalmelanophages that presents as symmetrical,hyperpigmented macules and patches that aredistributed over the forehead, temples, cheeks, andneck. The condition most often occurs in darkerskinned individuals and is frequently resistant totreatment. Here we present a patient of Egyptiandecent with a lacy reticulated LPP eruption on theface.
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December 2016

Raynaud Phenomenon.

JAMA Dermatol 2015 Dec;151(12):1400

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http://dx.doi.org/10.1001/jamadermatol.2015.0916DOI Listing
December 2015

Treatment of Scarring Alopecia in Discoid Variant of Chronic Cutaneous Lupus Erythematosus With Tacrolimus Lotion, 0.3.

JAMA Dermatol 2015 Oct;151(10):1113-6

Ronald O. Perelman Department of Dermatology, New York University School of Medicine, New York, New York.

Importance: Discoid lupus erythematosus (DLE) is a chronic variant of cutaneous lupus erythematosus, an autoimmune inflammatory disorder of the skin. Lesions are often localized to the scalp and can result in permanent scarring, disfiguration, and irreversible alopecia. Although DLE usually responds to topical or intralesional corticosteroids and/or oral antimalarials, some DLE is resistant to these treatments or adverse effects limit their effectiveness.

Observations: Three patients with treatment-refractory, biopsy-proved DLE were prescribed a novel, off-label preparation of tacrolimus lotion, 0.3%, in an alcohol base as an adjunct to oral antimalarial therapy. All 3 patients demonstrated improvement in lesion severity and hair regrowth with the use of this regimen after 3 months and continued improvement thereafter. We report a retrospective analysis of these 3 cases.

Conclusions And Relevance: This report is, to our knowledge, the first mention of tacrolimus being used in a lotion formulation to treat DLE lesions, resulting in hair regrowth. Topical tacrolimus lotion, 0.3%, in an alcohol base may be a potential therapeutic option for patients with DLE that is refractory to first-line therapies and who risk late-stage disease with permanent scarring alopecia.
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http://dx.doi.org/10.1001/jamadermatol.2015.1349DOI Listing
October 2015

How microRNAs modify protein production.

J Invest Dermatol 2015 May;135(5):1-5

Ronald O. Perelman Department of Dermatology, New York University School of Medicine, New York, New York, USA.

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http://dx.doi.org/10.1038/jid.2015.99DOI Listing
May 2015

Dialogue: Cutaneous lupus erythematosus: a lone Wolf?

Lupus Sci Med 2015 1;2(1):e000090. Epub 2015 Apr 1.

H de Granollers , Granollers , Spain.

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http://dx.doi.org/10.1136/lupus-2015-000090DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4386466PMC
April 2015

Sarcoidosis.

Dermatol Online J 2015 Dec 16;21(12). Epub 2015 Dec 16.

New York University School of Medicine.

We present a 28-year-old man with a one-year history of cutaneous lesions in old scars and tattoos with concomitant subcutaneous nodules and myopathy. A skin biopsy specimen showed cutaneous sarcoidosis. We discuss the multiple aspects of this case, which represent unique presentations of this systemic disease as well as review isomorphic and isotopic responses.
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December 2015

White fibrous papulosis of the neck.

Dermatol Online J 2014 Dec 16;20(12). Epub 2014 Dec 16.

New York University School of Medicine.

We present a 76-year old woman with a five-year history of asymptomatic, white papules that were grouped on the lateral and posterior aspects of the neck, inferior axillae, and central mid-back. The histopathologic findings showed thickened collagen bundles. A diagnosis of white fibrous papulosis of the neck was made, which is believed to be a manifestation of intrinsic aging. There are no treatments for white fibrous papulosis of the neck. One hypothesized approach is the application of a topical anti-oxidant to reduce free-radical induced aging.
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December 2014

Necrolytic acral erythema.

Dermatol Online J 2013 Dec 16;19(12):20709. Epub 2013 Dec 16.

New York University School of Medicine.

Necrolytic acral erythema is a rare, cutaneous manifestation of hepatitis C virus infection that is characterized by erythematous, violaceous or dusky papules, blisters, and/or erosions in the early stages and by well-demarcated, hyperkeratotic, targetoid plaques with a peripheral rim of macular erythema, secondary lichenification and hyperpigmentation, and overlying fine micaceous or necrotic-appearing scale in the later stages. Because most topical modalities prove ineffective, treatment of the underlying viral infection or therapeutic zinc supplementation are required for clinical improvement.
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December 2013

Granulomatous dermatitis related to silicone implant.

Dermatol Online J 2013 Dec 16;19(12):20708. Epub 2013 Dec 16.

New York University School of Medicine.

Silicone in liquid and gel implantation may induce granuloma formation and migration. Although there are many complications associated with solid silicone implantation, there have been no published reports of distant granuloma formation. We present a case of a woman with clinical and serologic findings that are consistent with systemic lupus erythematosus and a histopathologic diagnosis of foreign body granulomatous dermatitis 20 years after solid silicone nasal implantation. We review the literature on silicone granulomas and their treatment and speculate on the potential etiologies of a challenging case presentation.
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December 2013

Dominant Th1 and minimal Th17 skewing in discoid lupus revealed by transcriptomic comparison with psoriasis.

J Invest Dermatol 2014 Jan 14;134(1):87-95. Epub 2013 Jun 14.

Laboratory for Investigative Dermatology, The Rockefeller University, New York, New York, USA; Center for Clinical and Translational Science, The Rockefeller University, New York, New York, USA. Electronic address:

Discoid lupus erythematosus (DLE) is the most common skin manifestation of lupus. Despite its high frequency in systemic lupus in addition to cases without extracutaneous manifestations, targeted treatments for DLE are lacking, likely because of a dearth of knowledge of the molecular landscape of DLE skin. Here, we profiled the transcriptome of DLE skin in order to identify signaling pathways and cellular signatures that may be targeted for treatment purposes. Further comparison of the DLE transcriptome with that of psoriasis, a useful reference given our extensive knowledge of molecular pathways in this disease, provided a framework to identify potential therapeutic targets. Although a growing body of data support a role for IL-17 and T helper type 17 (Th17) cells in systemic lupus, we show a relative enrichment of IFN-γ-associated genes without that for IL-17-associated genes in DLE. Extraction of T cells from the skin of DLE patients identified a predominance of IFN-γ-producing Th1 cells and an absence of IL-17-producing Th17 cells, complementing the results from whole-skin transcriptomic analyses. These data therefore support investigations into treatments for DLE that target Th1 cells or the IFN-γ signaling pathway.
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http://dx.doi.org/10.1038/jid.2013.269DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3858414PMC
January 2014

Lupus-erythematous-associated interstitial granulomatous dermatitis.

Dermatol Online J 2012 Dec 15;18(12):31. Epub 2012 Dec 15.

The Ronald O. Perelman Department of Dermatology, New York University School of Medicine, USA.

A 41-year-old woman with a prior diagnosis of lupus erythematous presented with a five-year history of small, erythematous, flesh-colored papules and nodules that coalesced into symmetrically-distributed plaques on her upper back. A biopsy specimen showed an interstitial, granulomatous mixed-cell dermatitis with eosinophils. These clinicopathologic findings are consistent with a diagnosis of lupus erythematous-associated interstitial granulomatous dermatitis.
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December 2012

Ulcerative sarcoidosis.

Dermatol Online J 2012 Dec 15;18(12):29. Epub 2012 Dec 15.

The Ronald O. Perelman Department of Dermatology, New York University School of Medicine, USA.

Sarcoidosis is a multi-system, granulomatous disease, which affects the skin in approximately 20 to 30 percent of cases. Recognition of cutaneous sarcoidosis can be challenging because of the wide range of skin lesion morphologies. Ulcerative sarcoidosis is uncommon. We present a 35-year-old woman with pretibial ulcerative sarcoidosis, indurated tattoos, and hilar lymphadenopathy.
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December 2012

Antiphospholipid-antibody-associated panniculitis.

Dermatol Online J 2012 Dec 15;18(12):18. Epub 2012 Dec 15.

The Ronald O. Perelman Department of Dermatology, New York University School of Medicine, USA.

A 60-year-old man presented with intermittent, tender, erythematous nodules on the legs that were associated with mild arthralgias. He was otherwise asymptomatic but reported a history of lupus anticoagulant antibodies that were discovered incidentally on laboratory screening at the approximate time that his lesions first occurred. A biopsy specimen showed a septal and lobular panniculitis with neutrophils, histiocytes, numerous eosinophils, foci of fibrosis, and fat necrosis but no vascular pathology. An elevated activated partial thromboplastin time (PTT), appreciably elevated levels of anti-beta-2 glycoprotein I antibody (IgM and IgG), and moderately elevated levels of anticardiolipin antibody (IgM and IgG) were present. The onset and recurrence of his skin condition coincided with increased antiphospholipid antibody levels and treatment with 81 mg aspirin daily was associated with improvement.
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December 2012