Lupus Erythematosus Tumidus Induced by Sex Reassignment Surgery

GISELE ZANDMAN-GODDARD, MICHAL SOLOMON, AVIV BARZILAI, and YEHUDA SHOENFELD

ABSTRACT.

We describe a case of sex reassignment surgery and the subsequent development of lupus erythematosus tumidus (LET). LET is characterized clinically by erythematous, succulent, edematous, nonscarring plaques in sun-exposed areas. Results of histological examination show perivascular and periadnexal lymphocytic infiltration and interstitial mucin deposition. This report emphasizes that environmental triggers, including prolonged exposure to significant doses of estrogens as part of sex reassignment surgery, may lead to the development of lupus in a nonpredisposed individual. (First Release August 1 2007; J Rheumatol 2007;34:1938-40)

Key Indexing Terms:

SEX REASSIGNMENT SURGERY
ESTROGEN
SYSTEMIC LUPUS ERYTHEMATOSUS
LUPUS ERYTHEMATOSUS TUMIDUS
SILICONE AUGMENTATION MAMMOPLASTY

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From the Department of Medicine C, Wolfson Medical Center, Holon; Department of Dermatology, Department of Medicine B, and The Center for Autoimmune Diseases, Sheba Medical Center, Tel-Hashomer; and Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.

G. Zandman-Goddard, MD, Head, Department of Medicine C, Wolfson Medical Center; M. Solomon, MD; A. Barzilai, MD, Department of Dermatology, Sheba Medical Center; Y. Shoenfeld, MD, Department of Medicine B, Center for Autoimmune Diseases, Sheba Medical Center, and Sackler Faculty of Medicine, Tel Aviv University.

Address reprint requests to Dr. G. Zandman-Goddard, Department of Medicine C, Wolfson Medical Center, Holon, Israel 58100. E-mail: goddard@wolfson.health.gov.il

Accepted for publication April 17, 2007.

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