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Malar rash caused by metal allergy in a patient with systemic lupus erythematosus.

机译:系统性红斑狼疮患者的金属过敏引起的斑疹性皮疹。

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BACKGROUND: A 61-year-old woman with an 8-year history of systemic lupus erythematosus presented with a non-pruritic, erythematous, malar rash. Previously, she had tested positive for antinuclear antibody and autoantibodies to double-stranded DNA and Ro/SSA, and had an elevated erythrocyte sedimentation rate. She wore eyeglasses with metal frames and had recently gained weight, which caused the eyeglasses to have increased contact area with her face. INVESTIGATIONS: Physical examination, autoantibody testing, measurement of complement C3 and C4 levels, measurement of erythrocyte sedimentation rate, hypersensitivity patch testing, dimethylglyoxime test of the patient's eyeglass frames. DIAGNOSIS: Delayed-type hypersensitivity reaction to nickel and possibly to cobalt dichloride in the patient's eyeglass frames, which caused a malar rash that mimicked acute cutaneous lupus erythematosus. MANAGEMENT: The rash resolved completely with contact avoidance with the eyeglass frames.
机译:背景:一名系统性红斑狼疮病史为8年的61岁妇女出现非瘙痒性红斑性皮疹。此前,她对双链DNA和Ro / SSA的抗核抗体和自身抗体测试呈阳性,并且红细胞沉降率升高。她戴着带有金属框架的眼镜,最近体重增加,这使眼镜与面部的接触面积增加。调查:体格检查,自身抗体测试,补体C3和C4水平的测量,红细胞沉降率的测量,超敏贴剂测试,患者眼镜架的二甲基乙二肟测试。诊断:对患者眼镜架中的镍以及可能对二氯化钴的迟发型超敏反应,引起了类似于急性皮肤红斑狼疮的黄斑疹。处理:避免接触眼镜架,完全消除了皮疹。

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