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H‐W. Lee, S‐E. Chang, M‐W. Lee, J‐H. Choi, K‐C. Moon, J‐K. Koh, Interstitial granulomatous dermatitis with plaques associated with antiphospholipid syndrome, British Journal of Dermatology, Volume 152, Issue 4, 1 April 2005, Pages 814–816, https://doi.org/10.1111/j.1365-2133.2005.06505.x
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Sir, Interstitial granulomatous dermatitis (IGD) with plaques is the analogue ‘en plaques’ of IGD with cutaneous cords and arthritis. It shows variable clinical appearances including annular plaques, papules, nodules and cutaneous cords.1 Histopathologically, IGD shows a granulomatous infiltrate with foci of collagen degeneration in the deep reticular dermis,1, 2 and is associated with autoimmune systemic diseases such as rheumatoid arthritis and systemic lupus erythematosus (SLE).1 We report a case of IGD with plaques in a 24‐year‐old man with antiphospholid syndrome (APS). To our knowledge, this is the first report of IGD with plaques associated with APS.
A 24‐year‐old Korean man was admitted to the rheumatology unit of our institution with a painful swelling of his left calf and a fever that had persisted for 7 days. Spontaneous deep vein thrombosis (DVT) was suspected, and venographic findings showed left femoral vein thrombosis. Laboratory findings included haematocrit 40·8%, white blood cell count 6·5 × 109 L−1, platelet count 282 × 109 L−1, erythrocyte sedimentation rate 67 mm in the first hour, activated partial thromboplastin time 58·2 s (normal 30·5–45) with elevated Russell viper venom time 54·4 s (normal 0–38·8), anticardiolipin IgG titre 26 GPL mL−1 (normal 0–22), β2‐glycoprotein I IgG titre 6 U mL−1, IgM titre 11 U mL−1 (borderline 5–8; positive ≥ 9) and fibrinogen 562 mg dL−1 (normal 200–400). He was positive for antinuclear antibody (× 40; cytoplasmic pattern) and autoantibody against double‐stranded DNA, but was negative for rheumatoid factor and other autoantibodies including anti‐RNP, anti‐Sm, anti‐Ro, anti‐La and anti‐Scl‐70. Other blood biochemistry tests, including level of D‐dimer, protein C, free protein S and antithrombin III, were normal. His past medical and medication history was not remarkable except for a 2‐year history of joint pain around both elbows and knees. Based on these findings the patient was diagnosed as having APS.
