Coexistentence of Morphea and DLE in a Patient with Beta Thalassemia Leading to a Diagnosis of Systemic Lupus Erythematous

Main Article Content

Marilyn Le
Payvand Kamrani
L. Claire Hollins

Keywords

morphea, discoid lupus erythematosus, autoimmune disorders, beta thalassemia, cutaneous lupus, limited scleroderma, systemic lupus erythematous

Abstract

Patients with autoimmune disorders are predisposed to developing a second autoimmune condition. This can be applied to cutaneous conditions as well. Morphea or localized scleroderma is an autoimmune inflammatory and fibrosing skin disorder due to increased collagen deposition.1,2 Patients with morphea are four times likelier of having a concomitant autoimmune disease.1 There have been cases of systemic lupus erythematosus (SLE) with morphea, but the co-occurrence of discoid lupus erythematosus (DLE) with morphea has been rarely reported, and never reported in patient with Beta-thalamessmia.1,2,7 Morphea and discoid lupus erythematosus can be found within one lesion or as separate diagnoses. In this case, we describe a patient with morphea and discoid lupus erythematous in the setting of beta thalassemia leading to diagnosis of SLE.

References

1. Leitenberger JJ, Cayce RL, Haley RW, Adams-Huet B, Bergstresser PR, Jacobe HT. Distinct autoimmune syndromes in morphea: a review of 245 adult and pediatric cases. Arch Dermatol. 2009;145(5):545-550. doi:10.1001/archdermatol.2009.79

2. Pham AK, Srivastava B, Deng A. Pregnancy-associated morphea: a case report and literature review. Dermatol Online J. 2017;23(1):13030/qt5qv9f9h3. Published 2017 Jan 15.

3. Bernárdez C, Prieto-Torres L, Macías E, et al. Concurrent presentation of cutaneous lesions of deep linear morphoea and discoid lupus erythematosus. Lupus. 2016;25(2):204-208. doi:10.1177/0961203315604911

4. Pascucci A, Lynch PJ, Fazel N. Lupus erythematosus and localized scleroderma coexistent at the same sites: a rare presentation of overlap syndrome of connective-tissue diseases. Cutis. 2016;97(5):359-363.

5. Mir A, Tlougan B, O'Reilly K, et al. Morphea with discoid lupus erythematosus. Dermatol Online J. 2011;17(10):10. Published 2011 Oct 15.

6. Castellino G, Govoni M, Padovan M, Rizzo N, Trotta F. Beta thalassaemic trait and systemic lupus erythematosus. Ann Rheum Dis. 2005;64(4):653-654. doi:10.1136/ard.2004.023689

7. Agrawal BK, Marwaha S, Bhatnagar M, Parry SA, Agrawal U. Association of Systemic Lupus Erythematosus and Beta Thalassaemia Trait- A Case Report. J Clin Diagn Res. 2016;10(6):OD03-OD4. doi:10.7860/JCDR/2016/19803.7933

8. Swamy, M. Narayana, T. A. Shilpa, and Stephen Benny. "Systemic lupus erythematosus and beta-thalassemia trait." APIK Journal of Internal Medicine 8.1 (2020): 22.