Cutaneous Involvement in Systemic Lupus Erythematosus: A Review for the Rheumatologist

Abstract

The majority of patients with systemic lupus erythematosus (SLE) have cutaneous manifestations at some point in their disease. The skin findings in lupus erythematosus are classified as lupus-specific or lupus-nonspecific based on histopathologic findings. Lupus-specific skin diseases include chronic cutaneous lupus erythematosus, subacute cutaneous lupus erythematosus, and acute cutaneous lupus erythematosus. There are subsets of skin lesions within each group and the likelihood of associated SLE varies amongst them. Lupus nonspecific lesions are more common in patients with SLE and tend to coincide with active systemic disease. Lupus nonspecific lesions may be seen as a feature of another disease process, including other connective tissue diseases. It is important for the rheumatologist to be familiar with the spectrum of cutaneous disease in lupus erythematosus to help prognosticate the likelihood of systemic disease and ensure patients receive timely dermatologic care with the goal of controlling disease activity to prevent damage.

Selected nursing interventions for systemic lupus erythematosus

“…People of all skin tones are at risk for skin damage from UV light from the sun, tanning salons, and indoor halogen lighting 4-6. UV light penetrates deep into the skin and can damage a person's DNA, which can cause an immune system response 9,13…”

“…Nonspecific mucosal and skin lesions, including nonscarring alopecia, vasculitis (inflammation of blood vessels in the skin), and urticaria, are common in SLE. Rashes and lesions cause pain, discomfort, and body image disturbances and may indicate inflammation in body organs and tissues 13,21,25…”

“…The first image features a lupusspecific malar rash sparing the nasolabial folds that may be flat or raised. 13,21,25 The second sidebar illustrates a lupus-specific papulosquamous subacute cutaneous lupus erythematosus, sometimes called "psoriasiform" because it resembles psoriasis. 13,21,25 The rashes in acute cutaneous lupus erythematosus (ACLE) malar rash and lupus-specific papulo squamous subacute cutaneous occur secondary to exposure to the sun and indoor lighting.…”

“…13,21,25 The second sidebar illustrates a lupus-specific papulosquamous subacute cutaneous lupus erythematosus, sometimes called "psoriasiform" because it resembles psoriasis. 13,21,25 The rashes in acute cutaneous lupus erythematosus (ACLE) malar rash and lupus-specific papulo squamous subacute cutaneous occur secondary to exposure to the sun and indoor lighting. Other specific lesions include chronic cutaneous lupus erythematosus and discoid lupus erythematosus (DLE), which may exist without systemic manifestations.…”

Cutaneous Lupus Erythematosus: An Overview of Clinical Manifestations

“…The approach to the treatment of signs and symptoms of lupus depends on the type and the severity of the disease. General recommendations for all patients include sunlight protection, proper diet and nutrition, exercise, smoking cessation, appropriate immunizations, and management of comorbid conditions [3]. This review study aims to provide a comprehensive overview of the clinical presentation, diagnosis, and treatment of the different subtypes of CLE to better understand this complex condition and its various subtypes.…”