Abstract
Skin disease is the second most common clinical manifestation of systemic lupus erythematosus after arthralgias. Skin lesions in lupus erythematosus (LE) are divided into lupus-specific and lupus-nonspecific findings. LE-specific skin lesions include chronic cutaneous LE, subacute cutaneous LE, and acute cutaneous LE. Chronic cutaneous LE typically includes localized, generalized, and hypertrophic LE; lupus panniculitis; chilblain lupus; and lupus tumidus. There are unique features to the pathophysiology of skin disease in LE because frequently the courses of skin and systemic disease are not similar in a given patient. The pathology in virtually all forms of cutaneous lupus erythematosus (CLE) is characterized by immune cell infiltration into the dermis, culminating in keratinocyte damage. This pattern has been termed the lichenoid tissue reaction or interface dermatitis. A CLE severity measure, the Cutaneous Lupus Erythematosus Area and Severity Index, has been developed and validated. Such a standardized approach should enhance prospective trials for CLE in the future.
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