Extravascular necrotizing palisaded granulomas as the presenting skin sign of systemic lupus erythematosus.

Obermoser, G; Zelger, B; Zangerle, R; Sepp, N · Br J Dermatol · 2002

case_report · Level V

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Abstract

We recently examined a patient who presented clinically with tender, erythematous papules associated with a febrile illness and polyarthralgias. Histopathological examination revealed extravascular palisaded neutrophilic granulomas, a skin reaction pattern originally described in Churg-Strauss disease but subsequently observed in a variety of other systemic disorders characterized by immune complex generation. A diagnosis of systemic lupus erythematosus (SLE) was established. To our knowledge, this is the first report of extravascular necrotizing palisaded granulomas as the presenting skin sign of SLE.

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