Prevalence of self-report photosensitivity in cutaneous lupus erythematosus

Foering, Kristen; Goreshi, Renato; Klein, Rachel S.; Okawa, Joyce; Rose, Mathew; Cucchiara, Andrew J.; Werth, Victoria P.

doi:10.1016/j.jaad.2010.12.006

Cited by 44 publications

(56 citation statements)

References 49 publications

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“…Compared to other reports, incidence of systemic involvement in SCLE patients was higher in the study group. 11,14,15 Similar observations in ACLE and CCLE were made by others. 7,10,16 LE-nonspecific skin lesions were seen exclusively in patients with SLE.…”

Section: Discussionsupporting

confidence: 81%

Cutaneous Manifestations of Lupus Erythematosus From a Tertiary Care Centre in Coastal Kerala

James¹,

Nair²

2017

jemds

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BACKGROUNDThe aim of this study was to describe the Lupus Erythematosus (LE)-specific and LE-nonspecific cutaneous manifestations of lupus erythematosus. MATERIALS AND METHODSCutaneous manifestations of lupus erythematosus in forty consecutive patients with LE who attended Dermatology department from January 2014 to June 2015 were studied. RESULTSMajority of the patients included in the study were female (65%). The most common age group affected was 20-40 years (47.5%). Photosensitivity was the most common symptom (45%). Forty five percent of patients in the study were diagnosed of systemic lupus erythematosus (SLE) according to the ACR criteria. LE-specific skin lesions were more common than LE-nonspecific lesions (95% vs. 40%). Chronic Cutaneous LE (CCLE) was the most common LE-specific skin lesion (85%). Only psoriasiform type of Subacute Cutaneous LE (SCLE) lesions were seen in the study group. Malar rash was the most common Acute Cutaneous LE (ACLE) lesion (87.5%). Features suggestive of systemic involvement were most commonly found in patients with ACLE and least in those with CCLE. Most common LE nonspecific lesion was non-scarring alopecia (32.5%) due to telogen effluvium. Cutaneous vascular disease in the form of palpable purpura of leucocytoclastic vasculitis (2.5%), periungual telangiectasia (7.5%), erythema multiforme (2.5%) and leg ulcers (5%) were the other LE-nonspecific skin lesions observed in the study. Patients with LEnonspecific skin lesion had more systemic involvement compared to those without it. CONCLUSION LE-specific lesions are more common and can act as a diagnostic clue for lupus. LE-nonspecific lesions are more commonly associated with systemic disease.

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Section: Discussionsupporting

confidence: 81%

Cutaneous Manifestations of Lupus Erythematosus From a Tertiary Care Centre in Coastal Kerala

James¹,

Nair²

2017

jemds

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“…Moreover, it has been suggested that patient history of photosensitivity does not necessarily correlate with photoprovocation results. The data on patient history of photosensitivity vary greatly in studies published in the literature (4,25,26), but a recent well-designed study on the prevalence of self-reported photosensitivity in a US population observed that 68% of the CLE patients reported prior or ongoing photosensitivity (27). Our present analysis revealed that 56.9% of CLE patients had a positive history of unusual reactions to sunlight.…”

Section: Discussionmentioning

confidence: 56%

Updated Analysis of Standardized Photoprovocation in Patients With Cutaneous Lupus Erythematosus

Ruland

Haust

Stilling

et al. 2013

Arthritis Care & Research

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Objective. To determine the frequency and reproducibility of standardized photoprovocation in patients with cutaneous lupus erythematosus (CLE) and report our long-term experience. Methods. Photoprovocation using a standardized protocol was evaluated retrospectively in 566 patients. A diagnosis of CLE was clinically and/or histologically confirmed in 431 patients, and 315 patients with polymorphic light eruption (PLE) were additionally included as controls. Data were statistically analyzed using an SPSS database. Results. A total of 61.7% of the 431 CLE patients exhibited a positive photoprovocation, with a significantly longer latency period for the development of skin lesions after ultraviolet (UV) A and/or UVB irradiation than PLE patients (P < 0.001). The frequency of positive photoprovocation varied among the CLE subtypes, and intermittent CLE was the most photosensitive disease entity (74.8%). Subsequent photoprovocation in 35 patients demonstrated that CLE patients with an initial positive result exhibited a significantly higher frequency of a positive photoprovocation at a later time point (P ‫؍‬ 0.013). However, an initial positive photoprovocation did not definitively predict a positive reaction at a later time point. Moreover, patient history of photosensitivity was not a predictor for the photoprovocation outcome. Conclusion. Standardized photoprovocation is a useful tool to reproducibly induce skin lesions and objectively evaluate photosensitivity in patients with CLE. These data further suggest that the reaction to UV light may change during the course of this heterogeneous disease and that photosensitivity should not be excluded in patients with a negative history of photosensitivity.

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“…85, 86 Rates vary depending on the type of lupus. 87, {Kim, 2013 #9253} 88 Wavelengths within the UVA and/or UVB are responsible for production of cutaneous lesions.…”

Section: Photoimmunological Diseasesmentioning

confidence: 99%

Photoimmunology

Elmets

Cala

2014

Dermatologic Clinics

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SYNOPSIS The discipline that investigates the biological effects of ultraviolet radiation on the immune system is called photoimmunology. Photoimmunology evolved from an interest in understanding the role of the immune system in skin cancer development, and why immunosuppressed organ transplant recipients are at greatly increased risk for cutaneous neoplasms. Ultraviolet radiation-induced damage DNA modifies the antigen presenting function of cutaneous dendritic cells, biases the immune response towards the generation of regulatory T-cells and stimulates epidermal keratinocyte production of immunosuppressive cytokines. In addition to contributing to an understanding of the pathogenesis of non-melanoma skin cancer, the knowledge acquired about the immunological effects of ultraviolet radiation exposure has provided an understanding of its role in the pathogenesis of other photodermatologic diseases such as polymorphous light eruption, chronic actinic dermatitis and cutaneous lupus erythematosus. This information has also been helpful in developing more effective and safer phototherapeutic devices for the treatment of a variety of cutaneous diseases.

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Prevalence of self-report photosensitivity in cutaneous lupus erythematosus

Cited by 44 publications

References 49 publications

Cutaneous Manifestations of Lupus Erythematosus From a Tertiary Care Centre in Coastal Kerala

Cutaneous Manifestations of Lupus Erythematosus From a Tertiary Care Centre in Coastal Kerala

Updated Analysis of Standardized Photoprovocation in Patients With Cutaneous Lupus Erythematosus

Photoimmunology

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