Discoid Lupus Erythematosus in Children: Clinical, Histopathologic, and Follow‐Up Features in 27 Cases

Abstract

Among 27 pediatric patients with a clinicopathologic diagnosis of discoid lupus erythematosus (DLE), 15 had localized cutaneous lesions and 12 had disseminated lesions. During a mean follow-up period of 36 months, seven patients (26%) developed systemic lupus erythematosus (SLE). Four of these patients were less than 10 years of age. No correlation was found between localized and disseminated lesions and evolution to SLE. Three of four patients with a positive family history for rheumatoid disease developed SLE (p < 0.05). Hyperpigmentation was significantly more frequent (p < 0.04) in children less than 10 years of age. There was a female predominance of 5:1 among patients less than 10 years of age. Our findings suggest that onset of DLE prior to 10 years of age does not indicate a greater risk of developing SLE. The occurrence of localized or disseminated lesions does not seem to influence the outcome.

Pediatric Discoid Lupus Erythematosus: successful treatment with antimalarials

“…Arthralgia and Raynaud's phenomenon are the most frequent systemic findings in pediatric DLE and inflammatory arthritis may herald progression to SLE. [ 2] The confined or disseminated character of the lesions, early onset of the disease (age of less than 10 years), disease duration, presence of antinuclear antibodies, and poor response to antimalarials are not predictive factors for progression to SLE. Antinuclear antibodies are positive in 19.2% children with DLE without SLE and in 87.5% with DLE and SLE.…”

“…[ 2] The association with SLE is seen in 23.5% of patients, www.pacificejournals.com/apalm eISSN: 2349-6983; pISSN: 2394-6466 a proportion higher than that observed in adult DLE. [3] Disseminated lesions are much more frequent in patients who fulfill the criteria for SLE (87.5% vs 34%) and hence may be a marker of poor prognosis.…”

“…A female predominance has been observed in some studies in childhood DLE (Moises-Alfaro et al -5:1) but not in others (Sampaio et al -2:1). [2,3] As in adults, the exact etiology of childhood DLE remains obscure. Reports of familial cases and a high concordance for clinical disease in monozygotic twins suggest a strong genetic component and altered cellular immunity in genetically predisposed individuals as factors in its pathogenesis.…”

Discoid Lupus Erythematosus in Childhood: A Report of Two Cases and Review of the Literature

“…Lokalize hastalıkta boyundan yukarı bölgede tutulum oranı %56 iken, jeneralize hastalıkta bu oran %44'dür. Fotosensitivite ortalama %40-100 oranında bildirilmiştir (1,6). Histopatolojik değerlendirmede epidermisde keratin tıkaçlar, bazen atrofi, bazal tabakada likefaksiyon dejenerasyonu, dermisde ödem ve fibrinoid dejenerasyon, perivasküler ve periadneksiyal lenfosit infiltrasyonu görülmektedir.…”

Cual es su diagnostico

“…4 Las artralgias y la afectación mucosa son menos frecuentes, así como las variantes de lupus cutáneo crónico, excepcionales en niños, pero con más riesgo de evolución a LES cuando están presentes (25% en niños vs. 5-10% en adultos). 4,5 De forma similar al caso que presentamos, es característico encontrar cuadros clínicamente muy polimorfos con solapamiento de diferentes formas de lupus cutáneo en el mismo paciente (Figuras 1-3).…”