Abstract
We report a 58-year-old MCTD patient with atrophic violaceus erythema on her cheek. Despite the use of topical 0.1% tacrolimus ointment, the lesion gradually enlarged. A histopathological examination showed a typical DLE type tissue reaction. The sebaceous glands had been destroyed by infiltrated lymphocytes. In addition, there were numerous xanthoma cells throughout the dermis, perivascular area, and vascular walls. These xanthoma cells contained granular substances showing fine yellow-orange autofluorescence under UV light, thus suggesting lipofuscin. A laboratory examination showed no hyperlipemia. Destruction of the sebaceous glands by inflammatory cells through the oxidation of the released lipids seemed to be responsible for the xanthomatous tissue reaction.
