Multiple eruptive dermatofibromas associated with altered immunity and systemic lupus erythematosus

Excerpt

A 29-year-old female with systemic lupus erythematosus (SLE) presented with multiple eruptive skin tumors within 3 months after immunosuppressive therapy of prednisolone 5 mg, mycophenolate mofetil 540 mg, and cyclosporine 25 mg twice per day for lupus nephritis. Dermatologists were consulted to evaluate the possibility of skin cancers, given the patient’s immunosuppression status. Physical examination revealed more than eight hyperpigmented, brownish papulonodules on the trunk and extremities (Fig. 1). Multiple eruptive dermatofibromas (MEDFs) were diagnosed based on consistent clinical presentation and histopathological features of dermatofibroma (DF). During the follow-up period, the levels of C3 and C4 complement components were within normal ranges (C3: 90–180 mg/dL; C4: 10–40 mg/dL); the anti-nuclear antibody titer remained unchanged at 1:1280 with a fine speckled pattern. The activity of SLE remained stable without deterioration of renal function or adjustment of immunosuppressive therapy. The number and size of DFs were also stabilized.

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