A 72-year-old man presented with a 2-year history of an asymptomatic rash on the trunk and upper extremities that progressed over 3 months and is aggravated by sunlight. There was no associated fever, joint pain, weight loss, shortness of breath, or malaise. Hismedications included atenolol, simvastatin, triamterenehydrochlorothiazide, aspirin, fenofibrate, gemfibrozil, and ranitidine, all of which have been unchanged for years. He had a generalized eruption on the chest, back, and arms that included erythematous scaly papules and plaques; some of the plaques are annular and serpiginous. A skin biopsy shows a vacuolar interface dermatitis with apoptotic keratinocytes, increased mucin in the dermis, and a superficial and mid-dermal chronic inflammatory infiltrate. Laboratories included a complete blood count, complete metabolic panel, and antinuclear antibodies, all of which were normal. Direct immunofluorescence showed positive deposition of immunoglobulin IgE and C3 in a linear pattern at the dermalYepidermal junction. The triamterenehydrochlorothiazide was discontinued, and the eruption cleared completely over the next 6 weeks with topical fluocinonide ointment twice daily.
- Drug-induced subacute cutaneous lupus erythematosus
ASJC Scopus subject areas
- Advanced and Specialized Nursing