Clinical, Histological and Immunopathological Features of 58 Patients with Subacute Cutaneous Lupus erythematosus

Parodi, Aurora; Caproni, Marzia; Cardinali, Carla; Bernacchi, Elisabetta; Panfilis, Giuseppe De; Zane, Cristina; Papini, Manuela; Veller, Farnase Cleto; Vaccaro, Mario; Fabbri, Paolo

doi:10.1159/000018307

Cited by 73 publications

(54 citation statements)

References 26 publications

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“…There are two morphologic variants of SCLE: annular and papulosquamous. A study of 58 SCLE patients found that 42% had annular SCLE and 39% exhibited papulosquamous SCLE, while 16% of patients showed features of both [18]. Other studies have found more papulosquamous SCLE [19] and [20].…”

Section: How Can We Differentiate the Cle Subtypes?mentioning

confidence: 99%

Cutaneous lupus erythematosus: Diagnosis and treatment

Okon¹,

Werth²

2013

Best Practice & Research Clinical Rheumatology

260

257

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Cutaneous lupus erythematosus encompasses a wide range of dermatologic manifestations, which may or may not be associated with the development of systemic disease. Cutaneous lupus is divided into several subtypes, including acute cutaneous lupus erythematosus, subacute cutaneous lupus erythematosus, and chronic cutaneous lupus erythematosus. Chronic cutaneous lupus erythematosus includes discoid lupus erythematosus, lupus erythematosus profundus, chilblain cutaneous lupus, and lupus tumidus. Diagnosis of these diseases requires proper classification of the subtype, through a combination of physical exam, laboratory studies, histology, antibody serology, and occasionally direct immunofluorescence, while ensuring to exclude systemic disease. Treatment of cutaneous lupus consists of patient education on proper sun protection along with appropriate topical and systemic agents. Systemic agents are indicated in cases of widespread, scarring, or treatment-refractory disease. In this review, we discuss issues in classification and diagnosis of the various subtypes of CLE, as well as provide an update on therapeutic management.

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Section: How Can We Differentiate the Cle Subtypes?mentioning

confidence: 99%

Cutaneous lupus erythematosus: Diagnosis and treatment

Okon¹,

Werth²

2013

Best Practice & Research Clinical Rheumatology

260

257

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“…The most widely accepted classification of LE-specific cutaneous involvement includes acute CLE (ACLE) with its localized and generalized forms, subacute CLE (SCLE) with its annular and papulosquamous forms and chronic CLE (CCLE) including discoid LE (DLE), lupus panniculitis and chilblain lupus. Some authors postulated to separate an intermittent CLE (ICLE) group covering lupus tumidus, while others handle this subtype as a form of CCLE [8,9].…”

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confidence: 99%

Clinical characteristics of cutaneous lupus erythematosus

Szczęch

Rutka

Samotij

et al. 2016

pdia

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13 IntroductionLupus erythematosus (LE) is a chronic autoimmune disease with a wide spectrum of presenting symptoms ranging from mild cutaneous manifestations in localized cutaneous LE (CLE) to severe, life-threatening internal organ damage in systemic LE (SLE). The etiology of LE remains unknown, although the environmental, genetic, viral and hormonal factors are taken into consideration as probable causes or precipitating factors of this disease [1,2].Skin involvement is seen in about 70-85% of all LE patients [3]. Sometimes skin involvement is the only manifestation of LE, while in other cases it could rather be a mild bystander of severe internal involvement. Isolated CLE is a rare disease, albeit it is still about 2 to 3 times more frequent than SLE [4]. Cutaneous features of LE can be classified into LE-specific and LE-nonspecific ones. LEspecific skin lesions usually appear only in patients with LE and thus can be handled as diagnostic ones (e.g. "ma- Aim: To analyze the clinical presentation of cutaneous variants of lupus erythematosus in terms of skin lesion spectrum and extracutaneous involvement. Material and methods: A total of 64 patients with cutaneous LE (CLE) were included. The study was based on the "Core Set Questionnaire" developed by the European Society of Cutaneous Lupus Erythematosus (EUSCLE). Clinical severity of skin lesions was evaluated with the Cutaneous Lupus Erythematosus Disease Area and Severity Index (CLASI). All results were subjected to statistical analysis. Results: Fifteen (23.4%) patients had an acute CLE (ACLE), 26 (40.6%) subacute CLE (SCLE) and 21 (32.8%) chronic CLE (CCLE). Two (3.2%) individuals only demonstrated urticarial vasculitis as a cutaneous manifestation of LE and these patients were excluded. Patients with ACLE were characterized by the earliest onset of the disease (mean age of 31.9 ±15.0 years; p < 0.001). On average, 4.8 ±1.8 criteria of systemic LE were found in the ACLE group compared to 2.7 ±1.3 criteria in SCLE and 2.5 ±1.5 criteria in CCLE (p < 0.001). The highest activity of skin lesions according to CLASI was found in the SCLE group (p = 0.002). On the other hand, the most severe skin damage was observed in CCLE (p < 0.01). Conclusions: Each variant of CLE differs significantly from the others in respect of various aspects of clinical manifestations. Due to a number of different variants of LE skin lesions, a unified classification of CLE still remains a challenge.

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“…Entre as manifestações clínicas, fotossensibilidade, alopecia, úlcera oral e fenômeno de Raynaud parecem sugerir pior prognóstico no lúpus cutâneo (16) . Outros estudos clínicos (6,17) sugerem que a sistematização do lúpus eritematoso cutâneo esteja associada com a extensão das lesões cutâneas, com a presença de fenômeno de Raynaud, úlceras orais, fotossensibilidade e positividade de anti-DNA. Estudo comparando marcadores de atividade lúpica em pacientes com LES e lúpus cutâneo (discóide ou subagudo) verificou que nefrite, artrite e títulos altos (≥1:320) de FAN estavam entre os fatores de risco para envolvimento sistêmico no lúpus (2) .…”

Section: Discussionunclassified

“…A pesquisa de autoanticorpos no soro de nossos pacientes mostrou diferença significante (p<0,04) dos anticorpos anti-DNA entre pacientes com LES (58,8%) e LECD (18,7% (17) . Anticorpo anti-Sm também tem sido considerado específico de LES, porém é detectado em apenas 30% dos casos (1) .…”

Section: Discussionunclassified