Cutaneous Lupus Erythematosus and Dermatomyositis: Utilizing Assessment Tools for Treatment Efficacy

Chong, Benjamin F.; Werth, Victoria P.

doi:10.1016/j.jid.2021.09.036

Cited by 4 publications

(3 citation statements)

References 77 publications

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“…Concurrently, common features of the clinical picture in DM are facial erythema and V-neck erythema. In most cases, histopathological pictures of skin specimens taken from patients with DM and CLE are indistinguishable [49,50]. However, with special immunohistochemical or transcriptomics techniques, it is possible to reveal the following histopathological features: myeloid dendritic cell infiltration in DM and plasmacytoid dendritic cell infiltration in CLE.…”

Section: Subacute Cutaneous Lupus Erythematosusmentioning

confidence: 99%

The Spectrum of Cutaneous Manifestations in Lupus Erythematosus: A Comprehensive Review

Fijałkowska,

Kądziela,

Żebrowska

2024

JCM

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Lupus erythematosus (LE) is an autoimmune inflammatory disease with complex etiology. LE may present as a systemic disorder affecting multiple organs or be limited solely to the skin. Cutaneous LE (CLE) manifests with a wide range of skin lesions divided into acute, subacute and chronic subtypes. Despite classic forms of CLE, such as malar rash or discoid LE, little-known variants may occur, for instance hypertrophic LE, chilblain LE and lupus panniculitis. There are also numerous non-specific manifestations including vascular abnormalities, alopecia, pigmentation and nail abnormalities or rheumatoid nodules. Particular cutaneous manifestations correlate with disease activity and thus have great diagnostic value. However, diversity of the clinical picture and resemblance to certain entities delay making an accurate diagnosis The aim of this review is to discuss the variety of cutaneous manifestations and indicate the clinical features of particular CLE types which facilitate differential diagnosis with other dermatoses. Although in diagnostically difficult cases histopathological examination plays a key role in the differential diagnosis of LE, quick and accurate diagnosis ensures adequate therapy implementation and high quality of life for patients. Cooperation between physicians of various specialties is therefore crucial in the management of patients with uncommon and photosensitive skin lesions.

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Section: Subacute Cutaneous Lupus Erythematosusmentioning

confidence: 99%

The Spectrum of Cutaneous Manifestations in Lupus Erythematosus: A Comprehensive Review

Fijałkowska,

Kądziela,

Żebrowska

2024

JCM

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“…Ideally, patient reported measures of quality of life, using tools as DLQI, Skindex-29 and CLEQoL should also be checked at baseline before treatment and regularly followed up. At present there is no specific, standardized measure of QoL in CLE although some have been proposed (111)(112)(113)(114).…”

Section: Guidelines Of Carementioning

confidence: 99%

Clinical aspects of cutaneous lupus erythematosus

Elmgren

Nyberg²

2023

Front. Med.

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Lupus erythematosus (LE) is an autoimmune inflammatory disease with a wide clinical spectrum from life-threatening multi-organ inflammation in systemic lupus erythematosus (SLE) to limited skin disease in cutaneous LE (CLE). The etiology of CLE is still not fully understood but a multifactorial genesis with genetic predisposition and certain environmental factors as triggers for the development are generally accepted features. Lesions can be induced and aggravated by UV-irradiation and smoking is linked to more severe forms of skin disease and to co-morbidity. Drugs, including many common medicines like antihypertensives, are known to induce subacute CLE (SCLE). The mechanisms involved have recently been shown to be part of the IFN-I pathway and new, specific treatments are currently in clinical trials. CLE is currently classified in subtypes based on clinical presentation and duration into acute CLE (ACLE), SCLE, and chronic CLE (CCLE). Distinct subtypes can be seen in individual patients or coexist within the same patient. Because of the confluent and overlapping picture between these subsets, serology, and histopathology constitute an important role guiding towards correct diagnose and there is ongoing work to update the classification. The Cutaneous Lupus Area Severity Index (CLASI) is a validated tool to measure activity and damage both in clinical trials but also for the clinician to evaluate treatment and follow the course of the disease among patients. CLE is known to have substantial impact on the life of those affected. Several tools have been proposed to measure QoL in these patients, currently Skindex-29 is probably the most used. Patient education is an important part of prevention of flares, including UV-protection and smoking cessation. First-line treatment includes topical corticosteroids as well as topical calcineurin inhibitors with the addition of systemic treatment with antimalarials in more severe or therapy resistant cases. Treatment specifically targeting CLE has been lacking, however novel potential therapies are in later phase clinical trials. In this review we aim to describe the different subsets of the cutaneous form in LE with focus on clinical aspects.

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“…Damage scores are based on dyspigmentation and scarring, including scarring alopecia. 61,62 Since the CLASI was developed and validated it has been used in two-thirds of clinical studies and trials of CLE outcomes. 64 Additional validated activity and damage scores for CLE have been developed.…”

Section: Disease Monitoringmentioning

confidence: 99%

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

2022

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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.

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Cutaneous Lupus Erythematosus and Dermatomyositis: Utilizing Assessment Tools for Treatment Efficacy

Cited by 4 publications

References 77 publications

The Spectrum of Cutaneous Manifestations in Lupus Erythematosus: A Comprehensive Review

The Spectrum of Cutaneous Manifestations in Lupus Erythematosus: A Comprehensive Review

Clinical aspects of cutaneous lupus erythematosus

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

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