Cutaneous lupus erythematosus: Diagnosis and treatment

Abstract

Cutaneous lupus erythematosus encompasses a wide range of dermatologic manifestations, which may or may not be associated with the development of systemic disease. Cutaneous lupus is divided into several subtypes, including acute cutaneous lupus erythematosus, subacute cutaneous lupus erythematosus, and chronic cutaneous lupus erythematosus. Chronic cutaneous lupus erythematosus includes discoid lupus erythematosus, lupus erythematosus profundus, chilblain cutaneous lupus, and lupus tumidus. Diagnosis of these diseases requires proper classification of the subtype, through a combination of physical exam, laboratory studies, histology, antibody serology, and occasionally direct immunofluorescence, while ensuring to exclude systemic disease. Treatment of cutaneous lupus consists of patient education on proper sun protection along with appropriate topical and systemic agents. Systemic agents are indicated in cases of widespread, scarring, or treatment-refractory disease. In this review, we discuss issues in classification and diagnosis of the various subtypes of CLE, as well as provide an update on therapeutic management.

Subacute Cutaneous Lupus Erythematosus in Older Man: Case Report

“…Current theories, point to a relation of multiple factors that lead to the cutaneous lupus development, including autoimmune induction, immune system damage and genetic susceptibility [5] [11].…”

“…The patient's history, clinical and laboratory tests, serology and histopathological examination should be the basis for CLE diagnosis [11] [12] [13]. Another classification form, proposed by Gilliam, separates the lesions according to their histopathology, being they erythematous specific and nonspecific lesions.…”

“…In addition to UV rays, several drugs can induce the onset of SCLE, such as terbinafine converting enzyme inhibitors. Skin lesions are not indurated, but there is a possibility of hypopigmentation with vitiligo [11] [15] [16].…”

“…Most SCLE patients tend to have mild systemic symptoms, especially myalgias and arthritis, whereas more severe systemic disorders such as central nervous system lupus and nephritis affect less than 10% of the cases [11] [17].…”

Treatment of lupus erythematosus of the eyelids with pulsed dye laser

“…This classification is based on a combination of clinical features, histological changes, laboratory abnormalities, and average duration of skin lesions [2].…”