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Ulcerating plantar keratoderma in association with systemic lupus erythematosus

L Scherschun

Department of Dermatology, Henry Ford Health System, Detroit, Michigan, USA

D P Fivenson

Department of Dermatology, Henry Ford Health System, Detroit, Michigan, USA; Department of Dermatology, Henry Ford Health System, 2799 West Grand Boulevard, Detroit, MI 48202-2608, USA.; dfivens1{at}hfhs.org

This report highlights the finding of ulcerative plantar keratoderma in two patients with systemic lupus erythematosus (SLE). Both patients suffered from painful plantar ulcerations and fissures; in one patient there was diffuse desquamation over the entire plantar surface, while the other patient's lesions were focal and accentuated over weight-bearing surfaces. Other etiologies for keratoderma including papulosquamoua disease, contact dermatitis, tinea and primary keratodermas were excluded. Both patients were resistant to multiple topical therapies including super-potent topical corticosteroids, vitamin D analogues and retinoids, but did report moderate relief with hydrocolloid dressings applied over super-potent topical corticosteroids and pressure off-loading measures. Lupus-associated keratoderma can be recurrent and recalcitrant to treatment, often necessitating aggressive therapy and particular attention to advanced wound care methodologies. While not a specific cutaneous sign of lupus, it should be recognized as a cause for considerable morbidity.

Key Words: keratoderma • wounds • plantar

Lupus, Vol. 10, No. 9, 650-652 (2001)
DOI: 10.1191/096120301682430258


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