2004
DOI: 10.1111/j.1365-4632.2004.02013.x
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Lupus erythematosus induced by medications, ultraviolet radiation, and other exogenous agents: A review, with special focus on the development of subacute cutaneous lupus erythematosus in a genetically predisposed individual

Abstract: Exogenous agents implicated in or suspected of precipitating subacute cutaneous lupus erythematosus (SCLE) and lupus erythematosus (LE) are reviewed. An illustrative case of environmentally induced SCLE is presented. A previously healthy 30-year male homozygous for the tumor necrosis factor-alpha (TNF-alpha) 308. A promoter allele developed SCLE after spending several hours removing fertilizer- and pesticide-containing hay from an agricultural barn in the springtime. The cutaneous eruption soon resolved, only … Show more

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Cited by 29 publications
(12 citation statements)
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“…The reasons for this are multiple and include all of the following: the interaction of genetic and environmental factors [1][2][3], the potential role of stochastic factors [1,4], the polygenic nature of inherited susceptibility to autoimmunity [1,2,5], the existence of distinct checkpoints or stages in the development of autoimmunity, each of which may require the contribution of separate genes [1,2], and finally, the possibility that diseases such as systemic lupus erythematosus (SLE) may, like cancer, be more a syndrome than a single entity and represent a common phenotype arising from multiple, distinct causes [1,5,6]. Given this inordinate complexity, the existence of common cellular abnormalities, which are shared by all or many of the major models of spontaneous autoimmunity, may provide invaluable clues to the pathogenesis of autoimmunity.…”
Section: Introductionmentioning
confidence: 99%
“…The reasons for this are multiple and include all of the following: the interaction of genetic and environmental factors [1][2][3], the potential role of stochastic factors [1,4], the polygenic nature of inherited susceptibility to autoimmunity [1,2,5], the existence of distinct checkpoints or stages in the development of autoimmunity, each of which may require the contribution of separate genes [1,2], and finally, the possibility that diseases such as systemic lupus erythematosus (SLE) may, like cancer, be more a syndrome than a single entity and represent a common phenotype arising from multiple, distinct causes [1,5,6]. Given this inordinate complexity, the existence of common cellular abnormalities, which are shared by all or many of the major models of spontaneous autoimmunity, may provide invaluable clues to the pathogenesis of autoimmunity.…”
Section: Introductionmentioning
confidence: 99%
“…3 The trigger for the onset of the disease may be trauma, primary irritation or exogenous agents such as ultraviolet light, drugs, pesticides, heavy metals or other elements. 2,14 The apoptosis of keratinocytes has been indicated as a key event in triggering cutaneous lupus lesions through various apoptotic pathways such as p53, tumor necrosis factor-alpha (TNF-α) and Fas/FasL. 5,15 It is speculated that the aberrant keratinocytes may be unable to express the essential proteins required to regulate apoptosis, and are hence unable to prevent the apoptosis induced by solar radiation, for example.…”
Section: Discussionmentioning
confidence: 99%
“…About 50% of the patients fulfil at least 4 of the ACR-criteria, and these patients commonly have high titers of anti-SSA or anti-SSB [33]. Drug-induced SCLE is not infrequent [34]. Considerable histological overlap exist between DLE and SCLE, and differentiation between them cannot be established from the histological picture alone [35].…”
Section: Subsets Of Lupus Dermatitis -Meaningful In Context Of New Inmentioning
confidence: 98%