Presentation
The presentation of new-onset idiopathic SCLE should prompt a careful review of systems and age-appropriate cancer screening, as SCLE may be a sign of an occult malignancy. [ncbi.nlm.nih.gov]
Entire Body System
- Fatigue
Patients with CLE reported having poor quality of life and experienced symptoms ranging from pain, pruritus and fatigue to photosensitivity. There is a limited number of studies examining PRO in patients with CLE. [ncbi.nlm.nih.gov]
Common symptoms Many people have these symptoms: Fatigue: Lupus causes mild to extreme fatigue. Even mild cases of lupus make it hard to do daily activities and exercise. Increased fatigue is a classic sign that a symptom flare is about to occur. [northshore.org]
We ask about general symptoms (anxious mood, depressed mood, fatigue, pain, and stress) regardless of condition. Last updated: January 31, 2019 [patientslikeme.com]
- Weakness
Organic neurologic disturbances produce behavioral aberrations and frank psychosis in some patients; in a few others, there are peripheral neuropathies, motor weakness, and diplopia. [medical-dictionary.thefreedictionary.com]
Findings of muscle weakness, Gottrons papules, sparing of the interphalangeal creases, dilated nailfold capillaries, and frayed cuticles (samitz sign) can aid in the clinical diagnosis. [jddonline.com]
She was diagnosed with relapsing-remitting multiple sclerosis in 2005 at age 27 after mentioning bilateral leg numbness and weakness at a routine follow up. An MRI scan of the brain was consistent with a demyelinating illness. [nzma.org.nz]
More than 90 percent of people with lupus will experience joint pain and weakness, according to the Lupus Foundation of America. Most of that discomfort is caused by the inflammation that lupus triggers. [healthline.com]
- Falling
[…] erythematosus, such as after sun exposure. discoid lupus erythematosus (DLE) a superficial inflammation of the skin, marked by red macules up to 3 to 4 cm in width, and covered with scanty adherent scales, which extend into spreading follicles that fall [medical-dictionary.thefreedictionary.com]
The lesion will also cause scarring and discoloration overtime while the growth in the scalp causes the hair fall with hair loss that may tend to become permanent when the lesion healed. [healthh.com]
Systemic therapies generally fall under one of three categories: antimalarials, immunomodulators (eg, dapsone and thalidomide), and immunosuppressives (eg, methotrexate and mycophenolate). [dx.doi.org]
Systemic therapies generally fall under one of three categories: antimalarials, immunomodulators, such as dapsone and thalidomide, and immunosuppressives, such as methotrexate and mycophenolate. [ncbi.nlm.nih.gov]
Respiratoric
- Nasal Ulcer
Oral and Nasal Ulcers About 25% of people with lupus experience lesions that affect the mouth, nose, and sometimes even the eyes. These lesions may feel like small ulcers or “canker sores.” [hopkinslupus.org]
Other lesions associated with ACLE include oral or nasal ulcers, hives, and/or temporary hair loss, which are replaced by new hair once the disease flare is treated. 2. Subacute cutaneous (SCLE) lupus can be divided into two categories: a. [kaleidoscopefightinglupus.org]
ulcers Palate, buccal, and tongue ulcers or Nasal ulcers (in the absence of other causes, such as vasculitis, Behçet disease, infection [herpesvirus], inflammatory bowel disease, reactive arthritis, and acidic foods) Joint disease Synovitis involving [merckmanuals.com]
Other lesions associated with ACLE include oral or nasal ulcers, hives, and/or temporary hair loss, which are replaced by new hair once the disease flare is treated. [mollysfund.org]
Jaw & Teeth
- Oral Ulcers
Of the 13 patients, 1 (8%) solely met the ACR criteria because of malar rash, discoid rash, photosensitivity, and oral ulcers, and 3 (23%) met the ACR criteria for malar rash, discoid rash, oral ulcers, and photosensitivity and had positive ANA and other [archderm.jamanetwork.com]
RESULTS: Patients with SCLE/SLE were more likely than those with only SCLE to have oral ulcers, positive anti-double-stranded DNA antibodies, and positive antinuclear antibody test findings using both sets of criteria. [ncbi.nlm.nih.gov]
ACLE Butterfly malar rash Symmetric Erythematous Edematous Mildly scaly 43. • Oral ulcerations 44. lesions on hands → Knuckles typically spared 45. • TEN-like lesions Full-thickness epidermal necrosis Denudation Bullae 46. [slideshare.net]
Skin
- Skin Lesion
Histopathological evaluation of the skin lesions revealed SCLE. Ro/SS-A and La/SS-B antibodies were detected in serum. Regression of skin lesions and hematologic disturbances was achieved after starting corticosteroid therapy. [ncbi.nlm.nih.gov]
The highest activity of skin lesions according to CLASI was found in the SCLE group (p = 0.002). On the other hand, the most severe skin damage was observed in CCLE (p < 0.01). [dx.doi.org]
- Dermatitis
Biopsy specimens of all 3 patients demonstrated an interface dermatitis. Treatment consisted of topical and/or systemic corticosteroids, photoprotection, and switching the chemotherapeutic regimens. [ncbi.nlm.nih.gov]
Atopic dermatitis (AD) is a common chronic inflammatory dermatitis of the skin. [archderm.jamanetwork.com]
The LE non-specific skin lesions do not exhibit interface dermatitis and can be seen in clinical settings other than LE (e.g. dermatitis herpetiformis-, epidermolysis bullosa acquisita-, and bullous pemphigoid-like LE) (2, 6). [medicaljournals.se]
- Papule
Subacute cutaneous lupus erythematosus (SCLE) is a form of cutaneous lupus erythematosus that most often presents as scaly, erythematous, papulosquamous, or annular papules and plaques in a photodistributed pattern. [ncbi.nlm.nih.gov]
Findings of muscle weakness, Gottrons papules, sparing of the interphalangeal creases, dilated nailfold capillaries, and frayed cuticles (samitz sign) can aid in the clinical diagnosis. [jddonline.com]
The papulous, desquamative subsets may be confused with psoriasis, and the annular subsets with annular erythema centrifugum. 5 The present case demonstrates the importance of the diagnostic differential of this infirmity. [scielo.br]
- Hyperkeratosis
The histopathology of CLE is characterized by an interface dermatitis with vacuolization of the basal layer, a predominantly lymphocytic, perivascular and periadnexal infiltrate, epidermal and follicular hyperkeratosis, deposit of positive PAS material [ncbi.nlm.nih.gov]
Lymphocytes extended to the overlying, slightly hyperplastic epidermis with vacuolar changes, numerous necrotic keratinocytes and hyperkeratosis with foci of parakeratosis. [lupus.bmj.com]
Patients and methods A RCLASI was designed with regard to the anatomical region (i.e. face, chest, arms) and morphological aspects (i.e. erythema, scaling/hyperkeratosis, oedema/infiltration, scarring/atrophy) of skin lesions and evaluated by nine dermatologists [dx.doi.org]
Bangert et al., 17 stated that the presence of hyperkeratosis, thickening of the basal membrane, extensive follicular damage and dense lymphocyte infiltrate involving the deep dermis are findings that favor a diagnosis of DLE. [scielo.br]
Histologic examination revealed hydropic degeneration of the basilar epithelial layer with atrophy of the epidermis and hyperkeratosis, there was a perivascular and periadnexal superficial and deep lymphocytic infiltrate in the dermis ( Figs 2 A and 2 [jco.ascopubs.org]
- Eczema
DLE: sarcoidosis, tuberculosis, leprosy, classic mycosis fungoides, cutaneous pseudolymphoma, granuloma faciale, nummular eczema, psoriasis, squamous and basal cell carcinoma, rosacea, lichen planus. ChLE: frostbites. [orpha.net]
DDX • SCLE o Photosensitive eczema o Psoriasis o Dermatophytosis o Annular erythemas 72. DDX • DLE PMLE Lymphoma cutis Sarcoidosis Leishmaniasis Cut. tbc Granuloma faciale LP 73. Diagnosis 74. [slideshare.net]
The Pediatric Eczema Elective Registry (PEER) study was established as part of the postmarketing commitments for the approval of this drug. [archderm.jamanetwork.com]
Workup
Systemic Lupus Erythematosus (SLE) Workup. (19 September 2016 updated.) Available online at http://emedicine.medscape.com/article/332244-workup. Accessed March 27, 2017. Fonti utilizzate nelle precedenti revisioni (2003 August). [labtestsonline.it]
[…] distinguished For patients who fail topical steroids, especially for management of systemic immunosuppression or antimalarial medication dosing and monitoring Clinical Cases Case 1 31-year-old woman with recurrent lesions on cheeks and scalp Negative workup [derm101.com]
(See Workup and Treatment .) SCLE lesions heal without scarring or atrophy, but they may result in dyspigmentation, which can be prominent. Severe systemic disease is unusual, but when it occurs, the patient may develop life-altering sequelae. [emedicine.medscape.com]
Treatment
To present a patient with rheumatoid arthritis (RA), who developed SCLE after treatment with TNF-α antagonists and rituximab. In a 31-year-old woman with RA leucopenia due to treatment with etanercept and adalimumab was observed. [ncbi.nlm.nih.gov]
It addresses treatment efficacy by focusing on level of evidence as well as study design and outcome measures. It includes a focused summary section on the level of evidence for different treatments used. [dx.doi.org]
Prognosis
The prognosis for this condition is generally good, although a small proportion of patients will go on to develop systemic lupus erythematosus. The occupational implications of this condition require thoughtful management in the military population. [ncbi.nlm.nih.gov]
[…] diagnosis of cutaneous lupus erythematosus / FlorianWeber, Peter Fritsch ; Photosensitivity in lupus erythematosus / Percy Lehmann, Annegret Kuhn ; Relationship between cutaneous and systemic lupus erythematosus / Christof Specker, Matthias Schneider ; Prognosis [worldcat.org]
Etiology
A mechanism explaining how unrelated drug classes can lead to subacute cutaneous lupus erythematosus has remained elusive, suggesting that there may be multiple etiologic pathways. [ncbi.nlm.nih.gov]
Etiology Etiology is still elusive but it is thought to be multifactorial, involving a genetic predisposition. [orpha.net]
Epidemiology
Epidemiology and socioeconomic impact of skin disease in lupus erythematosus. Lupus. 1997; 6 (2):96–104. [ PubMed ] [ Google Scholar ] 3. Petri M. Epidemiology of systemic lupus erythematosus. [ncbi.nlm.nih.gov]
Search of the Rochester Epidemiology Project database identified 683 medical records for review. [dx.doi.org]
Epidemiological studies have reported that up to 23% of patients with cutaneous lupus erythematosus (CLE) develop systemic lupus erythematosus (SLE), with some progressing over several years. 1 As these data have been important in estimating one’s risk [archderm.jamanetwork.com]
Pathophysiology
Though the pathophysiology of CLE has yet to be fully characterized, current research provides direction for future research and therapies. [ncbi.nlm.nih.gov]
However, a complete understanding of the diverse pathophysiological mechanisms and interactions does not exist. [academic.oup.com]
Prevention
INTRODUCTION: Treatment and prevention are of critical importance in patients with cutaneous lupus erythematosus (CLE), as the disease can have a devastating effect on patient well-being and quality of life. [ncbi.nlm.nih.gov]
Summary Continued research to understand the mechanisms driving CLE will provide new methods for prevention and treatment of cutaneous lesions. [dx.doi.org]