Denny L. Tuffanelli

Nodular (keloidal) scleroderma

Two patients with progressive systemic sclerosis (PSS) developed keloidal-like nodules within areas of thickened skin. This extremely unusual event is most likely a keloidal response to the early inflammatory component of scleroderma in patients who are either genetically at risk for keloid formation or in areas of the skin that have a high predilection for keloid formation such as the chest.

Collagen-vascular disease: An update

LUPUS ERYTHEMATOSUS 1. Definition and diagnostic criteria A. Lupus erythematosus (LE) is a multisystem disorder.The spectrum of the diseaseruns from a relatively benign cutaneous eruption to a severe, potentially fatal systemic disease. B. Criteria for the classification of systemic lupus erythematosus (SLE) (American Rheumatism Association 1982 revision) I. Malar rash 2.Discoid lupus erythematosus lesions 3.Photosensitivity-by history or observation 4. Oral ulcers-usually painless, observed by physician 5. Arthritis-nonerosive, involving two or more joints 6.Serositis-pleuritis or pericarditis 7. Renal disorder-proteinuria (>500 tsig] day) or cellular casts 8. Central nervous system disorder-seizures or psychosis (absence of known cause) 9. Hematologic disorder-hemolytic anemia, leukopenia «4000/mm3) ; or thrombocytopenia «IOO,OOO/mm3) 10. Immunologic disorder-+LE prep, abnormal titer of antinative (n)DNA and antiSm, false-positive VDRL II. Antinuclear antibody C. If four or more criteri a are present serially or simultaneously during any period of observation, the patient is said to have SLE. II. Classification of clinical findings