Bullous SLE: response to methotrexate and relationship with disease activity

Malcangi, Giuseppina; Brandozzi, Giuliano; Giangiacomi, Mirella; Zampetti, M; Danieli, Maria Giovanna

doi:10.1191/0961203303lu241cr

Cited by 50 publications

(33 citation statements)

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“…In this study, patients having bullous skin lesions had systemic flares that were also reported previously by Malcangi, et al . [21] An association between concomittant lupus nephritis and bullous lesions had been documented by Ng, et al [22] but no such association has been documented in this study.…”

Section: Discussioncontrasting

confidence: 43%

Cutaneous manifestations of systemic lupus erythematosus in a tertiary referral center

Kole

Ghosh

2009

Indian J Dermatol

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Background:Systemic lupus erythematosus (SLE) is an autoimmune disease with multiorgan involvement. The skin is the second most commonly affected organ. SLE with skin lesions can produce considerable morbidity resulting from painful skin lesions, alopecia, disfigurement, etc. Skin lesions in patients with lupus may be specific (LE specific) or may be non specific (LE non specific). Acute cutaneous LE (Lupus specific) has a strong association with systemic disease and non-specific skin lesions always indicate disease activity for which patients present to rheumatologists and internists. Therefore, a thorough understanding of the cutaneous manifestations of SLE is essential for most efficient management.Aims:The aims of this study were to evaluate the patterns and prevalence of skin lesions in patients with SLE and to assess the relationship between skin lesions and other systemic involvement.Materials and Methods:At the Department of Rheumatology and Clinical Immunology, IPGME&R in Kolkata, 150 patients with SLE fulfilling the clinical and laboratory criteria of the American Rheumatology Association (updated 1982) were examined and followed-up for cutaneous manifestations between January 2002 and January 2007.Results:Skin lesions were important clinical features. About 45 patients (30%) presented with skin lesions although all patients had skin lesions during the follow-up period. Skin changes noted were as follows: Lupus specific lesions: malar rash in 120 patients (80%), photosensitive dermatitis in 75 patients (50%), generalized maculopapular rash in 40 patients (26.67%), discoid rash in 30 patients (20%), subacute cutaneous lupus erythematosus (SCLE) in 5 patients (3.34%), lupus profundus in 5 patients (3.34%). The lupus non-specific lesions were non-scarring alopecia in 130 patients (86.67%), oral ulcers in 85 patients (56.67%), vasculitic lesions in 50 patients (33.34%), bullous lesions in 15 patients (10%), Raynaud's phenomenon in 10 patients (6.67%), pyoderma gangrenosum in 2 patients (1.34%), erythema multiforme in 10 patients (6.67%), and nail fold infarcts in 2 patients (1.34%); however, mucosal discoid lupus, lichenoid discoid lupus, livedo reticularis, sclerodactyly, etc. were not detected. Patients having lupus-specific skin lesions e.g., malar rash were associated with systemic involvement, whereas those having lupus non-specific skin lesions were associated with disease flare.Conclusions:Skin lesions in patients with SLE are important disease manifestations and proper understanding is essential for diagnosis and efficient management.

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Section: Discussioncontrasting

confidence: 43%

Cutaneous manifestations of systemic lupus erythematosus in a tertiary referral center

Kole

Ghosh

2009

Indian J Dermatol

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“…Type VII collagen is the major component of anchoring fibrils at the dermal-epidermal junction, and is the target of autoimmunity in patients with bullous SLE [19]. There has been at least one report of bullous eruption as the first clinical sign of SLE relapse [20] suggesting that skin damage can be a marker of disease activity.…”

Section: Discussionmentioning

confidence: 99%

Bullous lesions as a manifestation of systemic lupus erythematosus in two Mexican teenagers

et al. 2010

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“…An association between BSLE and lupus nephritis is debated . In our literature review of pediatric BSLE cases, we found 21 of 33 (64%) cases that had renal involvement, and 12 of these (36%) were confirmed lupus nephritis.…”

Section: Discussionmentioning

confidence: 76%