Chronic cutaneous lupus erythematosus. Clinical, laboratory, therapeutic, and prognostic examination of 62 patients

Abstract

Chronic discoid lupus erythematosus (DLE) is a common condition. Sixty-two patients with biopsy-proved, active DLE were observed and their conditions were analyzed for clinical, laboratory, and therapeutic data. Fifty-six patients had disease limited to the skin-26 localized and 30 widespread (above and below the neck). At the time of follow-up examination, active disease was present in 32 patients, 28 of whom had widespread DLE. Six patients had DLE as a manifestation of systemic LE (SLE). In four patients, the DLE preceded the development of SLE. Laboratory abnormalities were substantially more common in patients with widespread DLE than in patients with localized DLE. An analysis of therapeutic results in this series confirmed the beneficial effects of intralesional corticosteroids and antimalarial agents and demonstrated relatively poor responsiveness to topical or oral corticosteroids.

Lupus Erythematosus Tumidus

“…16 The mean age at onset of the disease is nearly the same as described for DLE; therefore, compared with SCLE or SLE, patients with LET are older when the disease begins. 44 Skin lesions of LET had already developed in a male patient when he was 9 months of age. 27 Since several patients whom we had observed for up to 15 years had shown no recurrence after local or systemic treatment, the disease might spontaneously resolve; however, this would need to be confirmed by longterm investigations in a greater number of patients.…”

Marcadores de envolvimento sistêmico no lúpus eritematoso crônico discóide

“…Os pacientes com LECD em 5% dos casos desenvolvem durante a sua evolução manifestações clínicas compatíveis com lúpus eritematoso sistêmico (LES) (2,4) . O diagnóstico do LECD é feito com base no quadro clínico e/ou histopatológico da lesão cutânea (5,6,7,8) . Em pacientes com LES lesões discóides são encontradas em até 8,82% dos casos (9) .…”

“…Em pacientes com LES lesões discóides são encontradas em até 8,82% dos casos (9) . O LECD pode existir como forma limitada, ou seja, lesões acima do pescoço, ou forma difusa com lesões acima e abaixo do pescoço (5) . Ainda que considerada pouco freqüente em LECD, Mayou et al (4) detectaram a presença de autoanticorpos no soro de aproximadamente 60% dos pacientes com LECD.…”

Which Skin Lupus Criteria are of More Value in Determining the Disease: A Greater View with the Help of Direct Immune Fluorescent (DIF)

“…On the other side, DLE is characterized by well-defined erythematosus scaly patches mostly seen on face and other sun exposed areas; palmoplantar lesions are rarely seen in DLE and can be disabling to the patients especially when we know they are refractory to the conventional treatments [16][17][18][19]. There is a variant of DLE called tumid lupus erythematosus (TLE) which is recognized by excess production of mucin in derma giving the skin a brawny appearance with indurations.…”

“…LE is clinically divided to three classes: systemic lupus with acute onset, sub-acute cutaneous type, and a chronic discoid form (discoid lupus erythematosus [DLE]). Occurring two to three times more often than SLE, cutaneous lupus is a variant of LE being able to bother the patients' daily life [1][2][3][4][5][6][7][8][9][10][11][12][13][14][15].On the other side, DLE is characterized by well-defined erythematosus scaly patches mostly seen on face and other sun exposed areas; palmoplantar lesions are rarely seen in DLE and can be disabling to the patients especially when we know they are refractory to the conventional treatments [16][17][18][19]. There is a variant of DLE called tumid lupus erythematosus (TLE) which is recognized by excess production of mucin in derma giving the skin a brawny appearance with indurations.…”