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Aktuelle Dermatologie 2025; 51(03): 78-82
DOI: 10.1055/a-2517-5956
Kasuistik

Übergang eines Lupus erythematodes tumidus in einen systemischen Lupus erythematodes – Fallbericht und Literaturübersicht

Transition of lupus erythematosus tumidus to systemic lupus erythematosus – case report and literature review
Sven Burmann
1   Klinik für Dermatologie, Venerologie und Allergologie, Helios St. Elisabeth Klinik Oberhausen,
,
Frederik Bertling
2   Pathologie Rhein-Ruhr, Mülheim an der Ruhr, Deutschland
,
Alexander Kreuter
1   Klinik für Dermatologie, Venerologie und Allergologie, Helios St. Elisabeth Klinik Oberhausen,
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Zusammenfassung

Der Übergang eines Lupus erythematodes tumidus (LET) in einen systemischen Lupus erythematodes (SLE) ist eine Rarität. Wir berichten über den Fall einer 63-jährigen Patientin, die mit einem vorbekannten LET in unserer dermatologischen Ambulanz vorstellig wurde und neu aufgetretene Effloreszenzen an den unteren Extremitäten aufwies. Serologische Untersuchungen zeigten einen Übergang von einer ANA-Negativität zu positiven Titern (1:320), begleitet von erhöhten Anti-dsDNA-Antikörpern und erniedrigtem Komplementfaktor C3, wodurch die Kriterien eines SLE erfüllt wurden. Im vorliegenden Fall, der durch die erweiterte Behandlungsgeschichte und zusätzliche Erkrankungen besonders herausfordernd war, wurde aufgrund des fortschreitenden systemischen Krankheitsbilds eine Behandlung mit Anifrolumab gewählt, um die Krankheitsaktivität gezielt zu kontrollieren und systemische Manifestationen zu unterdrücken. Dieser Fall illustriert die Bedeutung einer engmaschigen Nachverfolgung bei Patienten mit LET, insbesondere bei Vorliegen von Risikofaktoren, um einen potenziellen Übergang zu einem SLE frühzeitig zu identifizieren und rechtzeitig therapeutische Maßnahmen zu ergreifen.

Abstract

The transition of lupus erythematosus tumidus (LET) to systemic lupus erythematosus (SLE) is a rarity. We report the case of a 63-year-old female patient who presented to our dermatology outpatient clinic with a previously known LET and new skin lesions on the lower extremities. Serologic examinations showed a transition from ANA negativity to positive values, accompanied by elevated anti-dsDNA antibodies and decreased complement factors, thus fulfilling the criteria for SLE. In the present case, which was particularly challenging due to the extended treatment history and additional diseases, treatment with anifrolumab was chosen due to the progressive systemic clinical picture, in order to specifically control disease activity and suppress systemic manifestations. This case illustrates the importance of close follow-up of patients with LET, especially in the presence of risk factors, in order to identify a potential transition to SLE at an early stage and to take timely therapeutic measures.

Schlüsselwörter

Lupus erythematodes tumidus (LET) - Übergang zu systemischem Lupus erythematodes (SLE) - Anifrolumab-Therapie

Keywords

Lupus erythematosus tumidus - transition to systemic lupus erythematosus - anifrolumab therapy


Publication History

Article published online:
12 March 2025

© 2025. Thieme. All rights reserved.

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