Autoimmune Connective Tissue Diseases

Observation: It was a 39-year-old farmer with no pathological history who consulted in May 2017 for a rash that had been evolving for about 6 months. The interrogation found intermittent poly arthralgia and a beginning marked by nodules of the limbs; evolving by pushing and leaving room for atrophic scars after an ulceration phase. The physical examination found painful nodules on palpation 1-2 cm in diameter disseminated all over the body. These nodules were associated with necrotic and scar lesions. A cutaneous biopsy of a nodule showed the presence of a predominantly lymphocytic, superficial and deep mononuclear infiltrate, which engulfed the hair follicles and infiltrated the hypodermis. The biological assessment showed: FAN> 1/1280 IU, Anti native DNA ≥11UI and Anti Sm ≥ 8 IU. The rest of the balance sheet was normal. The diagnosis of deep lupus Kaposi-Irgang type was retained. Prednisone treatment at a dose of 1mg / kg / day with hydroxychloroquine at 4mg / kg / day resulted in a clear regression of the lesions after 8 weeks of treatment.