Neurophils and sub epidermal nuclear dust

Neurophils and sub epidermal nuclear dust

This is a feature of early lupus erythematous particularly on the face. If neutrophils and nuclear dust are seen beneath an interface dermatitis pattern then the diagnosis of early discoid lupus erythematous is highly likely. (Ackerman)

The interface pattern may be very mild with only a few lymphocytes perivascularly and at the DEJ but there is often some mucin deposited locally in the dermis even in very early discoid lupus. Mucin plus the nuclear dust helps to diagnose early discoid lupus rather than dermatomyositis.

Though lymphocytes are the inflammatory cells seen in most lupus cases neutrophils in the dermal papillae are seen in early discoid and bullous lupus erythematous.