Original Research Article
Year: 2019 | Month: July | Volume: 6 | Issue: 7 | Pages: 11-18
Role of Histopathology in Diagnosis of Cutaneous Lupus Erythematosus: A Cross Sectional Observational Study
Maitrayee Saha1, Bhawna Bhutoria Jain2, Sanchita Ghosh3, Sarbani Chattopadhyay4, Debabrata Bandyopadhyay5
1MD(Path), Department of Pathology, Saroj Gupta Cancer Centre and Research Institute, Thakurpukur Cancer Hospital, Kolkata.
2MD (Path), Associate Professor, Department of Pathology, Medical College & Hospital, Kolkata.
3MD(Path), Assistant Professor, Department of Pathology, Medical College & Hospital, Kolkata.
4MD(Path), Professor, DDME, Swasthya Bhawan, Kolkata.
5MD(Derm), Professor, Department of Dermatology, Venereology & Leprosy, Medical College & Hospital, Kolkata.
Corresponding Author: Bhawna Bhutoria Jain
ABSTRACT
Lupus erythematosus (LE) is a multisystem disease with a broad range of clinical manifestations ranging from an isolated cutaneous eruption at one end to a fatal systemic illness at the other. Cutaneous lupus erythematosus may be subdivided into acute, subacute, or chronic based upon the constellation of clinical, histologic, and immunofluorescence findings. Definitive diagnosis prior to treatment initiation is essential as it is a chronic relapsing disease requiring regular-follow-up.
Aims: The objectives of this study are to define and characterize the spectrum of histopathological changes in cutaneous lupus erythematosus and to correlate the clinical findings such as lesion size, site and morphology with its histology and to differentiate from other simulating lesions.
Methods: It is a cross-sectional observational study at post graduate medical college done for the period of eighteen months. Prior ethical approval was taken from institutional ethical committee. Cases were referred from Dermatology OPD of clinically diagnosed cutaneous LE. Detailed history and physical findings were noted. Each case was diagnosed by histopathological examination and confirmed by Lupus band test in selected cases. Descriptive statistics was done using Microsoft excel.
Results: A total of 48 cases were clinically diagnosed as cutaneous lupus erythematosus, 13 male and 35 female. Age of presentation ranged from 5 years to 67 years. Among various subtypes; chronic cutaneous LE (CCLE) was the most frequent subtype most of which presented as discoid lesions. The comparative distribution of histopathological features of the CLE cases, on the basis of which, the lesions are sub classified into ACLE, SCLE and CCLE, along with clinical correlation, were tabulated.
Conclusion: Histopathological examination is indispensable in the diagnosis of LE. The commonest histological feature clinching the diagnosis in our study was interface dermatitis with vacuolar degeneration of the basal keratinocytes and perivascular and periadnexal lymphocytic infiltrate.
Key words: Cutaneous, lupus erythematosus, discoid, lupus tumidus, lupus panniculitis, histopathology
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