RT Book, Section
A1 Sontheimer, Clayton J.
A1 Costner, Melissa I.
A1 Sontheimer, Richard D.
A2 Kang, Sewon
A2 Amagai, Masayuki
A2 Bruckner, Anna L.
A2 Enk, Alexander H.
A2 Margolis, David J.
A2 McMichael, Amy J.
A2 Orringer, Jeffrey S.
SR Print(0)
ID 1161332248
T1 Lupus Erythematosus
T2 Fitzpatrick's Dermatology, 9e
YR 2019
FD 2019
PB McGraw-Hill Education
PP New York, NY
SN 9780071837798
LK accessmedicine.mhmedical.com/content.aspx?aid=1161332248
RD 2024/04/19
AB AT-A-GLANCEA  group  of  heterogeneous  illnesses  that  have  in  common  the  development  of  immunity  to  self-nucleic  acids  and  their  associated  proteins,  with  skin-only  disease  at  one  end  of  the  spectrum  and  severe  visceral  involvement  at  the  other.Skin  lesions  may  be  specific  to  lupus  or  nonspecific,  being  seen  in  other  conditions  as  well.Acute  cutaneous  lupus  erythematosus  (malar  rash)  is  almost  always  associated  with  underlying  visceral  involvement.  Subacute  cutaneous  lupus  patients  meet  American  College  of  Rheumatology  systemic  lupus  erythematosus  criteria  approximately  50%  of  the  time  (but  typically  express  only  mild  systemic  clinical  manifestations).  Chronic  cutaneous  lupus  (classic  discoid  lupus  erythematosus,  lupus  panniculitis,  chilblain  lupus,  and  tumid  lupus  erythematosus)  patients  most  often  have  skin-only  or  skin-predominant  disease.Classical  discoid  lupus  erythematosus  causes  scarring  and  can  be  permanently  disfiguring.  Subacute  cutaneous  lupus  and  acute  cutaneous  lupus  erythematosus  are  highly  photosensitive  and  are  characteristically  nonscarring.Lupus  erythematosus–nonspecific  skin  lesions  include  nonscarring  alopecia,  mouth  ulcers,  photosensitivity,  Raynaud  phenomenon,  vasculitis/vasculopathy,  and  bullous  systemic  lupus  erythematosus,  among  others.  They  often  herald  a  systemic  lupus  erythematosus  flare.Treatment  consists  of  physical  sun  protection,  topical  sunscreens,  local  and  short-term  systemic  glucocorticoids,  antimalarials,  retinoids,  thalidomide/lenalidomide,  conventional  immunosuppressives,  and  biologic  therapies.Lupus  erythematosus  occurs  much  more  commonly  in  women  (9:1  female-to-male  ratio).Both  systemic  lupus  erythematosus  and  cutaneous  lupus  erythematosus  are  associated  with  upregulation  of  type  1  interferon  signaling.