Lupus erythematosus: systemic and cutaneous manifestations

Hydroxychloroquine and smoking in patients with cutaneous lupus erythematosus

“…A growing number of medications have been noted to induce SCLE, including naproxen sodium, phenytoin, diltiazem, thiazides, tumour necrosis factor inhibitors, terbinafine and antihistamines. 8 Interestingly, the very medications used to treat SLE, including hydroxychloroquine and quinacrine, have also been implicated in the development or worsening of CLE lesions. 10,11 CCLE is subdivided into classic discoid (D)LE, hypertrophic ⁄ verrucous DLE, mucosal DLE, lichen DLE, LE profundus ⁄ LE panniculitis, LE tumidus, chilblain LE, and other rare variants.…”

“…Localized ACLE is characterized by erythema over the malar eminences of the face and bridge of the nose (butterfly rash), typically sparing the nasolabial folds. 7 Generalized ACLE is a diffuse papular erythema of the face, limbs or upper trunk, which resembles a viral exanthem or drug eruption, 8 and is present in 35% of patients with SLE. 9 Lesions develop quickly, and last for hours to days.…”

Bilaterally Symmetrical Alopecia With Reticulated Hyperpigmentation

“…6,8 Less than 20% of human patients with DLE are reported to develop SLE. 6 Whereas inflammatory lesions, sometimes leading to permanent alopecia, are often seen on the scalp of humans with DLE, other patients can have alopecic patches without clinically visible inflammation; such lesions resemble those of the autoimmune alopecias pseudopelade or alopecia areata. 10 The purpose of this report is to describe a unique alopecic form of CCLE in an adult dog that subsequently manifested signs of SLE.…”

“…The duration of the dermatosis and the presence of a lymphocyte-rich interface dermatitis and mural folliculitis warrant their inclusion, using the current human classification, under the umbrella of CCLE. 6,8 Classic DLE, the most common form of human CCLE, usually manifests as well-demarcated red-purple macules or papules that develop into coin-shaped ''discoid'' plaques with peripheral hyperpigmentation. 6 As the lesions progress, there is central depression, scarring, depigmentation, and telangiectasia.…”

“…8 Second, LE-specific skin disease, also known as cutaneous lupus erythematosus (CLE) sensu stricto, is further divided into acute, subacute, and chronic CLE based on the duration of the lesions (ACLE, SCLE, and CCLE, respectively). 6,8 Within this nosology, discoid LE (DLE) represents a unique clinical variant of CCLE. In contrast, lupus-nonspecific skin lesions (eg, vasculitis or subepidermal vesicular lesions) are seen not only in LE but also as part of other diseases.…”