Abstract Lymphocytic thrombophilic arteritis is a recently described entity, histopathologically characterized by lymphocytic vasculitis that affects the arterioles of the dermo-hypodermic junction, associated with deposition of fibrin and a luminal fibrin ring. A 49-year-old female patient presented with achromic maculae and a well-defined ulcer on the medial aspect of the left lower limb. The biopsy showed intense inflammatory infiltrate in the papillary dermis with a predominance of lymphocytes, and medium-caliber vessels surrounded by mononuclear infiltrates in the deep reticular dermis. Masson’s trichrome staining showed intense destruction of the muscle layer of the vascular wall and a fibrin ring. Good clinical response was attained with azathioprine. The authors believe that the ulceration might be another clinical presentation or represent an atypical progression of this condition.

Abstract: Lupus erythemathosus is a chronic, relapsing disease with acute, subacute, and chronic lesions. Effluvium telogen occurs in the setting of systemic activity of the disease, and cicatricial alopecia results from discoid lesionsin on the scalp. Other types of alopecia, like alopecia areata, may rarely be found in lupus. Frontal fibrosing alopecia is characterized by frontotemporal hairline recession and eybrow loss. Histophatologically, it cannot be differentiated from lichen planopilaris.It is controversial whether frontal fibrosing alopecia is a subtype of lichen planopilaris.. A pacient with chronic lichenoid lupus erythematosus is described with clinical, histophatological and dermoscopic features of frontal fibrosing alopecia.We have not been able to find in the literature cases of frontal fibrosing alopecia as a clinical manifestation of lupus.

A fibromatose digital infantil ou tumor de Reye é um tumor fibroso benigno de etiologia desconhecida, presente ao nascimento ou com aparecimento no primeiro ano de vida. Caracteriza-se por nódulos firmes, únicos ou múltiplos, normocrômicos ou eritematosos, localizados nas falanges, com tendência à regressão espontânea.

Infantile digital fibromatosis or Reye's tumor is a benign fibroproliferative tumor, the etiopathogenesis of which has yet to be fully clarified. It typically presents at birth or in the first year of life and is characterized by a firm, flesh colored or erythematous nodule or nodules located on the digits. These lesions tend to regress spontaneously.

FUNDAMENTOS: A capilaroscopia é método não invasivo e reprodutível capaz de analisar diretamente os capilares na região periungueal, auxiliando no diagnóstico diferencial das doenças do tecido conectivo. OBJETIVOS: Estudar, por meio da capilaroscopia periungueal, pacientes com lúpus eritematoso cutâneo crônico, lúpus eritematoso sistêmico e grupo controle. MÉTODOS: Foram analisados 70 pacientes pela capilaroscopia periungueal, sendo 37 com lúpus eritematoso cutâneo crônico e 33 com forma sistêmica, comparados a 32 indivíduos sadios. RESULTADOS: A presença de capilares ectasiados (p=0,027; p=0,001), enovelados (p=0,001; p=0,007) e em saca-rolhas (p=0,011;p=0,005), além de hemorragias capilares (p=0,004; p=0,001) foram parâmetros capazes de discriminar os dois grupos de pacientes do grupo controle. A variável capilar enovelado demonstrou ser preditiva para o diagnóstico de lúpus eritematoso sistêmico (OR=8,308). As variáveis independentes capilares ectasiados (OR=12,164) e hemorragias capilares (OR=5,652) foram preditoras para lúpus eritematoso cutâneo crônico. CONCLUSÃO: A capilaroscopia é útil na prática clínica, pois pacientes com alterações capilaroscópicas específicas parecem ter maior probabilidade de desenvolver lúpus eritematoso. As variáveis preditoras independentes para lúpus eritematoso sistêmico foram capilares enovelados e para lúpus eritematoso cutâneo crônico foram capilares ectasiados e hemorragias capilares.

BACKGROUND: Capillaroscopy is an useful diagnostic tool that is non-invasive, reproducible, able to assess the capillaries in the periungal region and that assists in the differential diagnosis of connective tissue diseases. OBJETIVES: The aim of the study was to distinguish chronic cutaneous lupus erythematosus and systemic lupus erythematosus from controls assessed by nailfold capillaroscopy. METHODS: Seventy patients with lupus erythematosus (37 with chronic cutaneous lupus erythematosus and 33 with systemic lupus erythematosus) were studied by the technique of capillary microscopy and compared to 32 controls. RESULTS: The presence of ectatic (p=0.027; p=0.001), meandering (p=0.001; p=0.007), corkscrew capillaries (p=0.011; p=0.005) and nailfold bleeding (p=0.004; p=0.001) distinguished between the two groups of patients (chronic cutaneous lupus erythematosus and systemic lupus erythematosus) from controls. The variable meandering loops could be predictive for systemic lupus erythematosus (OR=8.308). The independent variables ectatic loops (OR=12.164) end nailfold bleedings (OR=5.652) were predictive for chronic cutaneous lupus erythematosus. CONCLUSIONS: Capillaroscopy can help in the management of patients, since the presence of typical capillaroscopic abnormalities seems to be related to the development of lupus erythematosus. The independent predictive variables for systemic lupus erythematosus were meandering loops, and, for chronic cutaneous lupus erythematosus, ectasic loops and nailfold bleedings.