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Simultaneous Occurrence in a Patient Using Oral Contraceptives

Peter M. Elias, MD

Arch Dermatol. 1973;108(5):716-718.

Abstract
A young woman simultaneously developed erythema nodosum (EN) and serological signs of lupus erythematosus (LE) while taking an oral contraceptive. Both the EN and LE disappeared following cessation of medication, then recrudesced with reinstitution of therapy. Substitution of an anovulatory preparation, which differed from the original by only a single methyl group on the estrogen moiety, resulted in a marked diminution of the clinical signs of EN and a virtual disappearance of serological abnormalities. In vivo skin tests and in vitro lymphocyte-transformation studies utilizing the constituent hormones in the drug did not produce evidence of cellular hypersensitivity. In the absence of demonstrable hypersensitivity, the association of EN and LE indicates that immune complex may contribute to the pathogenesis of EN.

Author Affiliations
Boston

From the Department of Dermatology, Harvard Medical School, Children's Hospital Medical Center, Boston.

Footnotes
Accepted for publication June 20, 1973.

Read before the Section on Dermatology at the

121st annual convention of the American Medical Association, San Francisco, June 19, 1972.

Reprint requests to Department of Dermatology, Children's Hospital Medical Center, 300 Longwood Ave, Boston 02115 (Dr. Elias).

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ABSTRACT