Multiple minute parakeratotic keratoses of the hands in a patient with systemic lupus erythematosus [11]
Journal
British Journal of Dermatology
Journal Volume
145
Journal Issue
4
Pages
682-684
Date Issued
2001
Author(s)
Abstract
Sir, A 25?year?old woman was diagnosed with systemic lupus erythematosus (SLE) and treated with prednisolone 80 mg day?1. The dosage was gradually tapered to 20 mg day?1 within 3 months, and then replaced by hydroxychloroquine sulphate 200 mg day?1 and prednisolone 5 mg day?1 until she consulted us with a 6?month history of peculiar papules on the hands. These lesions had developed during the treatment with prednisolone and gradually increased in number. There was no specific symptom except mild itching. No other family members had similar skin lesions. Physical examination revealed groups of pinhead?sized, skin?coloured, keratotic, seed?like pits on the dorsal and volar aspects of her hands, especially the DIP, PIP and MP joints (Fig. 1). Histopathological examination of the keratotic pits revealed epidermal depressions filled with compact, cornoid lamella?like parakeratotic columns, under which the granular layers were markedly decreased or absent. A few dyskeratotic or vacuolated keratinocytes under the parakeratotic column were seen (Fig. 2). Between the parakeratotic columns, the epidermis was of normal thickness and pattern. The patient was treated with tretinoin cream (0�P05%) twice daily, but no response was noted in 3 months.
Type
letter