Multiple Eruptive Dermatofibromas in a Patient With Systemic Lupus Erythematosus Treated With Methylprednisolone

Patient history revealed that the patient had presented to a hospital five years earlier due to the complaints including photosensitivity, malar rash, oral aft, hair loss, fatigue, and arthralgia and had been diagnosed as having systemic lupus erythematosus (SLE) depending on the clinical signs and symptoms including an erythrocyte sedimentation rate of 83 mm/hour and positive antinuclear antibodies and anti-double stranded deoxyribonucleic acid. MEDFs can be seen in all ages and the lesions often occur on the torso.4 Histopathologically, MEDFs include a dense polymorphic infiltrate of mononuclear cells including fibroblasts, myofibroblasts, and histiocytes and thick hyaline collagen bundles in the periphery.4,5 Almost 69% of MEDF cases have an underlying disease and 83% of these underlying diseases are associated with immune dysregulation. The levels of basic fibroblast growth factor and platelet-derived growth factor, both of which promote fibroblast proliferation, have been shown to be elevated in the serum of the patients co-presenting with MEDF and SLE, which could explain the growth risk of DF.1,3,5 The role of immunosuppressive drugs in the development of MEDF could be explained by the fact that MEDF results from an abortive immunoreactive process that can be triggered by the drugs that downregulate the T-cells.2,4 Although rarely seen in clinical practice, MEDF can be seen in SLE patients using steroids or other immunosuppressive drugs.