Palisaded neutrophilic and granulomatous dermatitis associated with systemic lupus erythematosus: possible involvement of CD163 M2 macrophages in two cases, and a review of published works.

Lupus 2018 Dec 30;27(14):2220-2227. Epub 2018 Oct 30.

1 Department of Dermatology, Kansai Medical University, Hirakata, Japan.

Background: Palisaded neutrophilic and granulomatous dermatitis (PNGD) is a commonly occurring condition related to systemic autoimmune disease. It is characterized histopathologically by a distinct pattern of granulomatous inflammation in the presence or absence of leukocytoclastic vasculitis. The properties of granulomatous cells in PNGD are still uncertain.

Objective: We sought further investigation on the phenotype of the infiltrated cells in PNGD from two patients with systemic lupus erythematosus (SLE) and reviewed the previous published reports in order to provide a comprehensive summary on the clinical features of PNGD in SLE.

Methods: The immunohistochemical features of granulomatous cells in PNGD associated with SLE were analyzed. Immunohistochemical studies were performed on sections from our two cases using antibodies against CD68, CD163, CD15, Factor XIIIa, myeloperoxidase and neutrophil elastase. The clinical characteristics of the SLE patients who developed PNGD were also evaluated. We included all cases retrieved through a PubMed search with the key words PNGD and SLE.

Results: Cutaneous lesions consisted of erythematous plaques distributed on the face and upper limbs in both cases. The infiltrated cells were mainly positive for CD68 and CD163, a phenotype suggestive of M2 macrophages. Some mature neutrophils and lymphocytes were also present. A review of the literature of PNGD associated with SLE revealed a predominance in females, high prevalence of lupus nephritis and a good response to systemic steroids, with frequent skin lesions relapses during tapering of the treatment.

Limitations: This study examined only two cases; the pathogenesis of the disease remains to be clarified.

Conclusion: PNGD lesions were abundantly infiltrated by M2 macrophages, suggesting that they may have a role in this condition. SLE accompanied by PNGD might be associated with lupus nephritis and frequent relapses of skin lesions.

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http://journals.sagepub.com/doi/10.1177/0961203318809892
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December 2018
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References

(Supplied by CrossRef)
Article in Medicine (Baltimore)
Finan MC et al.
Medicine (Baltimore) 1983
Article in Semin Arthritis Rheum
Bremner R et al.
Semin Arthritis Rheum 2004
Article in Am J Dermatopathol
Coutinho I et al.
Am J Dermatopathol 2015
Article in Dermatol Clin
Rosenbach M et al.
Dermatol Clin 2015
Article in J Am Acad Dermatol
Hantash BM et al.
J Am Acad Dermatol 2008
Article in Arch Dermatol
Finan MC et al.
Arch Dermatol 1983
Article in J R Soc Med
Calonje JE et al.
J R Soc Med 1993
Article in J Cutan Pathol
Deen J et al.
J Cutan Pathol 2018
Article in J Am Acad Dermatol
Diette KM et al.
J Am Acad Dermatol 1984
Article in Trends Immunol
Mantovani A et al.
Trends Immunol 2004
Article in Blood
Xu W et al.
Blood 2006

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