Linear lupus erythematosus profundus involving the muscle with an intractable deep ulcer, successfully treated with surgical excision

摘要

Lupus erythematosus profundus (LEP) is an uncommon clinical variant of cutaneous lupus erythematosus [1], The disease course is chronic and characterized by multiple episodes of remission and exacerbation. Although various drugs are used for the treatment of LEP, cases with refractory ulcer, although rare, have been reported [2]. Here, we describe a case of LEP with an intractable deep ulcer requiring surgical treatment. A 57-year-old woman presented with 5-year history of erythema on the right buttock. The lesion enlarged slowly with distal progression and then a skin ulcer developed one year prior to her visit to our hospital. Physical examination revealed a large, band-like, indurated, erythematous plaque on the inside on the lateral side of the right buttock, with a deep ulcer at the proximal portion (figure 1A). No clinical features of systemic lupus erythematosus (SLE) were present. Magnetic resonance imaging (MRI) showed an area of hyperintensity consistent with the indurated erythematous plaque (figure 1B, arrows).