To clarify the relationship between discoid lupus erythematosus (DLE) and systemic lupus erythematosus (SLE), we have studied clinically 15 patients with widespread DLE.The patients were divided into four grades according to the extent of their cutaneous lesions.Thirteen of 15 patients had widespread chronic discoid lesions as their initial manifestation.The ratio of females to males was approximately 1 : 1. The average age at onset was 39 yerars old, and the most common age was between 20 and 40 years.In four of five patients (all in Grade IV and men), the cutaneous lesions appeared after the age of 40 years. In many patients with widespread DLE, clinical and laboratory abnormalities were observed, such as fever, arthralgia, fatigability, photosensitivity, leucopenia, elevated erythrocyte sedimentation rate, hypergammaglobulinemia, proteinuria, but the incidence of LE cells, positive LE test, chronic BFP was much less in widespread DLE than SLE. Two patients (Grade IV) fulfilled the ARA criteria for SLE.These findings suggest that DLE and SLE are closely related diseases.
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