A Clinical Study of the Cutaneous Manifestations of Lupus Erythematosus

Abstract

BACKGROUND Lupus Erythematosus (LE) is a group of heterogenous autoimmune diseases with an array of manifestations ranging from cutaneous lesions to life-threatening systemic manifestations. Cutaneous manifestations are the second most common feature and it serves as an important diagnostic aid. The nonspecific skin lesions are associated with more active disease. The aim of the study is to study the pattern and prevalence of cutaneous manifestations in LE and to study the correlation between cutaneous manifestations and systemic involvement. MATERIALS AND METHODS Study comprised of 48 patients of lupus erythematosus who attended the Department of Dermatology and Venereology in a tertiary referral centre from a period of November 2010 to November 2012. Patients were subjected to detailed clinical examination, routine investigations, ANA, anti-dsDNA, ANA profile, non-lesional skin biopsy for lupus band test. RESULTS 48 patients were taken for the study. The peak incidence was in the age group of 30-40 (33.33%) yrs. There was female predominance, the ratio being 5.86:1. Discoid Lupus Erythematosus (DLE) constitutes 37.5% and Systemic Lupus Erythematosus (SLE) 62.5%. Majority of DLE patients (38.89%) presented late in 5-9 yrs., whereas SLE patients presented early within 1-6 months (50%). Most frequent presenting features were arthralgia (54.17%), oral ulcers (45.83%). Renal system was the most common system affected (16.67%). Most common haematological abnormality was anaemia and raised ESR (40%). Most common immunological abnormality was raised ANA in 66.7% and raised anti-dsDNA (60%). Most frequent biochemical abnormality was albuminuria and raised 24-hours urine protein. Lupus band was positive in 58.33% and all had renal involvement. Mortality was 6.67%. CONCLUSION In this study, we got comparable results in epidemiological parameters like age and distribution with other studies. The incidence of ANA negative SLE was higher (33.33%) in our study. Though majority of patients with renal involvement had a positive lupus band test, a statistical significance could not be sought in this regard on account of low sample size.