RT Book, Section
A1 Costner, Melissa I.
A1 Sontheimer, Richard D.
A2 Goldsmith, Lowell A.
A2 Katz, Stephen I.
A2 Gilchrest, Barbara A.
A2 Paller, Amy S.
A2 Leffell, David J.
A2 Wolff, Klaus
SR Print(0)
ID 56075741
T1 Chapter 155. Lupus Erythematosus
T2 Fitzpatrick's Dermatology in General Medicine, 8e
YR 2012
FD 2012
PB The McGraw-Hill Companies
PP New York, NY
SN 978-0-07-166904-7
LK accessmedicine.mhmedical.com/content.aspx?aid=56075741
RD 2024/04/23
AB |PrintLupus  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  and  are  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  systemic  lupus  erythematosus  criteria  about  50%  of  the  time  (but  typically  express  only  mild  systemic  clinical  manifestations),  and  chronic  cutaneous  lupus  (discoid  lupus  erythematosus,  lupus  panniculitis,  chilblain  lupus,  and  tumid  lupus  erythematosus)  patients  most  often  have  skin-only  or  skin-predominant  disease.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's  phenomenon,  and  vasculitis/vasculopathy,  among  others.  They  often  herald  a  systemic  lupus  erythematosus  flare.Treatment  consists  of  sunscreens,  local  and  systemic  (short-term)  glucocorticoids,  antimalarials,  retinoids,  immunosuppressives,  thalidomide,  and  biologic  therapies.Lupus  erythematosus  occurs  much  more  commonly  in  women  (9:1  female-male  ratio).Both  systemic  lupus  erythematosus  and  cutaneous  lupus  erythematosus  are  associated  with  upregulation  of  class  I  interferon  signaling.