Focus Rheums| Dr. Jekyll or Mr. Hyde? (video)

An official publication of the ACR and the ARP serving rheumatologists and rheumatology professionals

ACR Image Competition 2021 Results, Part 4

Marina Barguil Macedo, MD, MSc; Featured Image from Latin America & the Caribbean   |  Issue: June 2022  |  

Lichenoid Cutaneous Lupus Erythematosus Mimicking Acanthosis Nigricans

The photos depict a 45-year-old woman who presented to the Lupus Clinic of the University of São Paulo, Brazil, with lesions closely resembling acanthosis nigricans on her neck (A and B). The lesions had been present for four months.

The patient had lived with systemic lupus erythematosus (SLE) for 16 years, but had been in remission for four years. During the previous month, she had developed inflammatory arthralgias in her hands.

ADVERTISEMENT
SCROLL TO CONTINUE

Despite a body mass index of 33.7 kg/m2, she had normal fasting glucose (92 mg/dL) and normal glycated hemoglobin (5.5%). She had a low C4 level of 8.0 mg/dL (reference range: 10–38 mg/dL). Skin histopathology demonstrated evidence of vacuolar interface dermatitis (C and D), with IgM-reactive cytoid bodies on papillary dermis.

ADVERTISEMENT
SCROLL TO CONTINUE

Methotrexate was initiated, with topical tacrolimus for lichenoid lupus erythematosus.

Marina Barguil Macedo, MD, MSc, recently completed a residency in rheumatology at the University of São Paulo, Brazil.

About the Contest

The Rheumatology Image Library is a highly accessed teaching resource. However, images showing manifestations of rheumatic disease on skin of color are under-represented, creating a significant educational gap. The 2021 Image Competition, held in conjunction with ACR Convergence 2021, encouraged the global rheumatology community to submit images that will help healthcare providers identify rheumatic disease manifestations in skin of color.

Here, we depict the image featured from Latin America and the Caribbean. In coming issues, we’ll publish the winning images from other regions. The images judged Best Overall, People’s Choice and East Asia & Pacific Region appeared in previous issues.

Related Articles

    Pulse Therapy & Lupus Nephritis: A 40-Year History, 1976–2016

    Corticosteroids still represent the mainstay of treatment of patients with active disease. They have been used for more than 60 years, and although prolonged use is associated with organ damage, they have been shown to be lifesaving in various phases of the history of the disease. History of Use First introduced in the late 1960s…