Systemic sclerosis with unusual panniculitis and overlying discoid lupus erythematous-like lesions

A 33-year-old men presented with systemic sclerosis accompanied by both unusual panniculitis and overlying discoid lupus erythematosus (DLE)-like skin changes on the left buttock. The lesion did not completely match either lupus erythematosus profundus or morphea profunda but featured clinical and pathological findings halfway between the two entities. No case report of co-existence of systemic sclerosis and morphea profunda was found in the literature, but there are three case reports of patients with systemic sclerosis and lupus erythematosus profundus. One of the three cases had DLE-like changes on the surface of the lesion, a clinical picture similar to our case. We speculated that the DLE-like changes in the overlying skin were due to local tissue ischemia. The accompanying panniculitis in our case was considered to be unique and somehow different from morphea profunda or lupus erythematosus profundus.