Adult late-onset atopic dermatitis presenting as cutaneous lupus in a male patient

Abstract

BackgroundAdult-onset atopic dermatitis (AD) diagnosis is very challenging as it presents with clinical heterogeneity and can mimic a broad of differential diagnoses such as mycosis fungoid and psoriasis. Herein, we report a lupus-like presentation of adult-onset AD. Clinical caseA 32-year-old man with a history of asthma presented to our department with a – lupus like – malar rash. Cutaneous lupus was suspected, but neither clinical, nor paraclinical or immunological assessment were in favor of the disease, skin biopsy revealed epidermal spongiosis, and eosinophilic infiltrate which, together with the patient's personal history and laboratory abnormalities, allowed the diagnosis of late-onset AD. Treatment with topical corticosteroids on the body and tacrolimus on the face was started, with good improvement. ConclusionAdult AD can simulate cutaneous lupus. Recognition of the clinical mimickers of AD is crucial for an accurate diagnosis.