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September 1962


Arch Dermatol. 1962;86(3):371-379. doi:10.1001/archderm.1962.01590090113025

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Lupus Erythematosus with Leg Ulcers. Presented by Dr. F. Reiss for Dr. Phillip Frost. 

History.—  A Chinese woman, who had hemolytic anemia and jaundice 4 years ago requiring splenectomy, came to the United States 6 months ago. She had shortness of breath and fatigue, generalized pruritic rash 3 months ago. Rash disappeared quickly, but leg ulcers developed.

Physical Examination on Admission.—  Examination showed a 52-year-old Chinese female—fatigued, pale, with 4 ulcers over lateral anterior and medial aspects of left leg. Enlarged liver and Grade 2 systolic murmur, loudest at apex, rales at bases of both lungs were present.Biopsy of ulcer edge: Skin ulcer with evidence of chronic dermatitis at base.

Laboratory.—  L.E. preparation was positive × 3; VDRL, 4 +; Kolmer, 3 + (5:1 titer); hematocrit, 30; Coombs' test, positive; total protein, 7.4; albumin, 2.4; globulin, 5.0 (marked increase γ-globulins on electrophoresis and slight increase in α2-globulin); electrolytes, normal. BUN, 11.5;

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