The ‘rat-bitten ear’: a rare case of multifocal ulcerated lupus panniculitis

[摘要] A 38-year-old female presented to the Department ofDermatology Outpatient with complaints ofautoamputation of her right ear lobule along withdry crusted ulcers over the left buttock and bilateralarms for the last 2 years. It started as a pruritic thicknonpinchable area of skin over the left buttock,followed by similar lesions on bilateral upper armsand right ear lobule within a month (Fig. 1). All thelesions ulcerated and crusted over 3 months. Onexamination, hyperpigmented indurated plaques withcrusted ulcer were present over the affected areas withthe nonpinchable surrounding skin. The right earlobule had a bitten-off appearance. She also hadphotosensitive, hyperpigmented macules over thebilateral malar area, diffuse nonscarring alopecia withshort, fine, brittle frontal hairs, nonspecific joint pain inthe large joints, more for bilateral knees. There is nohistory of other oral or nasal ulcers, dyspnoea, cloudyurine, neurologic symptoms, or other systemic illness.

[学科分类] 皮肤病学