Discoid Lupus Research Articles

Dermoscopic criteria of discoid lupus erythematosus: An observational cross-sectional study of 28 patients.

Discoid lupus erythematosus (DLE) affects mainly the head and neck and lesions heal with scaring. Early diagnosis of DLE is crucial; dermoscopy may enable early diagnosis and help to assess the prognosis of well-established lesions. To describe the dermoscopic features of DLE and to correlate them with the histological findings, site and duration of DLE. This study included 28 patients diagnosed as DLE based on clinical and histopathological examination. We examined the lesions clinically, dermoscopically and histopathologically. Evaluated dermoscopic variables were based on data in the available literature and on our observations. Whitish scales (89.3%), arborizing blood vessels (85.7%), follicular plugging (82.1%), and pigmentation (82.1%) were the commonest dermoscopic findings. Radial arrangement of arborizing blood vessel in between a radially arranged perifollicular whitish halo (starburst pattern) (39.3%) was noticed for the first time in this study. Rosettes (57.1%) were also seen. There was significant agreement between many dermoscopic and pathological findings with high sensitivity and specificity of many dermoscopic variants in the diagnosis of DLE. Follicular plugging, perifollicular whitish halo, starburst pattern, follicular red dots and rosettes were detected in early stages of the disease but structureless whitish areas and telangiectasia need more time to develop. We examined our patients at the time of presentation only without prospective monitoring and we had a relatively small sample size. Dermoscopy helps in the diagnosis of DLE at different body sites.

Squamous Cell Carcinoma Complicating Plaque of Lupus Erythematosus - A Case Series

Lupus Erythematosus is a multisystem disorder with a wide spectrum of clinical presentations ranging from cutaneous involvement to widespread systemic involvement. Squamous cell carcinoma formation in cutaneous lesions of LE is rare but had greater chances of metastases. Here, we report two cases, one of Discoid Lupus Erythematosus and other of Systemic Lupus Erythematosus complicated by development of squamous cell carcinoma over cutaneous lesions.

Treatment of Hyperpigmented Discoid Lupus Erythematosus With Jessner's Peel: A Case Report

Discoid lupus erythematosus (DLE) is the most common type of chronic cutaneous lupus erythematosus and is categorized by well-demarcated, often hyper or hypopigmented macules or papules that gradually progress into discoid plaques. Lesions are most commonly found above the neck, particularly on the face, scalp, and ears.1Lupus, Jessner’s Peel

Linear childhood discoid lupus erythematosus along a Blaschko's line of the arm

AbstractLinear childhood discoid lupus erythematosus (DLE) is a rare variant of DLE with a linear distribution that preferentially occurs on the face and scalp of children. We report a rare case of linear childhood DLE on the Blaschko's line of his left upper arm of a 7‐year‐old Japanese boy with 4‐year history of the disease. He was positive for anti‐single‐stranded DNA antibodies, but still showed no systemic symptoms during the 3‐year follow‐up period. We reviewed previous reports on linear childhood DLE and found that patients with nonfacial/nonscalp skin lesions are significantly more likely to be positive for autoantibodies.

Update on trichoscopy: Integration of the terminology by systematic approach and a proposal of a diagnostic flowchart.

Trichoscopy represents a non-invasive diagnostic modality widely used in daily practice. Despite the common perception that this technique has been fairly established, some key issues remain to be addressed. Complexity and inconsistency in terminology in past literature are likely to confuse investigators when they are recording, reporting, and retrieving the findings. In addition, a diagnostic algorithm adopting sufficiently integrated and updated findings is not readily available. By adopting a systematic review approach, this review attempted to redefine major trichoscopic findings and integrate their synonyms individually into the most frequently used terms besides identifying and discussing terms which potentially cause confusion. The findings are categorized into five subgroups: hair shaft, follicular, perifollicular, scalp findings, and hair distribution pattern abnormalities. The calculation of sensitivities and positive predictive values of such redefined findings was conducted by reviewing the descriptions in the past literature on major hair diseases, including alopecia areata, androgenetic alopecia/female pattern hair loss, telogen effluvium, trichotillomania, lichen planopilaris, frontal fibrosing alopecia, central centrifugal cicatricial alopecia, discoid lupus erythematosus, folliculitis decalvans, tinea capitis, and dissecting cellulitis, to confirm the diagnostically meaningful findings for representative diseases. This attempt redefined, for instance, yellow dots, short vellus hairs, exclamation mark hairs, black dots, and broken hairs as the findings of diagnostic significance for alopecia areata and hair diameter diversity, peripilar sign, and focal atrichia for androgenetic alopecia/female pattern hair loss. An updated diagnostic flowchart is proposed with the instructions to maximize its usefulness. Current limitations and future perspectives of trichoscopy as well as other emerging non-invasive diagnostic modalities for hair diseases are also discussed.

B Cell Signatures Distinguish Cutaneous Lupus Erythematosus Subtypes and the Presence of Systemic Disease Activity.

Cutaneous lupus erythematosus (CLE) is a chronic inflammatory skin disease characterized by a diverse cadre of clinical presentations. CLE commonly occurs in patients with systemic lupus erythematosus (SLE), and CLE can also develop in the absence of systemic disease. Although CLE is a complex and heterogeneous disease, several studies have identified common signaling pathways, including those of type I interferons (IFNs), that play a key role in driving cutaneous inflammation across all CLE subsets. However, discriminating factors that drive different phenotypes of skin lesions remain to be determined. Thus, we sought to understand the skin-associated cellular and transcriptional differences in CLE subsets and how the different types of cutaneous inflammation relate to the presence of systemic lupus disease. In this study, we utilized two distinct cohorts comprising a total of 150 CLE lesional biopsies to compare discoid lupus erythematosus (DLE), subacute cutaneous lupus erythematosus (SCLE), and acute cutaneous lupus erythematosus (ACLE) in patients with and without associated SLE. Using an unbiased approach, we demonstrated a CLE subtype-dependent gradient of B cell enrichment in the skin, with DLE lesions harboring a more dominant skin B cell transcriptional signature and enrichment of B cells on immunostaining compared to ACLE and SCLE. Additionally, we observed a significant increase in B cell signatures in the lesional skin from patients with isolated CLE compared with similar lesions from patients with systemic lupus. This trend was driven primarily by differences in the DLE subgroup. Our work thus shows that skin-associated B cell responses distinguish CLE subtypes in patients with and without associated SLE, suggesting that B cell function in skin may be an important link between cutaneous lupus and systemic disease activity.

Pediatric discoid lupus erythematosus: Short report.

Pediatric discoid lupus erythematosus (DLE) is a rare inflammatory skin disorder. This article aims to review all the available clinical and therapeutic data on reported cases of pediatric DLE. A systematic review of the literature was conducted using Pubmed and Embase with no limitation on publication date, sex, or nationality. Thirty-two articles were included with 201 cases, a mean age of 8.9 years (2 months-16 years) and an F:M ratio of 1.8. Lesions were located on the head and neck in 58.5% and were disseminated in 36.5% of the cases. Associated symptoms were pruritus (10.1%) and alopecia (8.7%). 12% progressed to systemic lupus erythematosus (SLE) and 14.5% had concurrent SLE. The only statistically significant predictor for progression to SLE was the onset of symptoms before or at the age of 10 years (p= 0.004). Treatments consisted mainly of sunscreens (26.3%), topical corticosteroids (24.3%), and oral antimalarials (25.3%). Retrospective nature of the included studies, small sample size, short duration of follow-up and limited data on the patients' demographics. Pediatric DLE affects mostly the head and neck, with a female predominance, a possible association with inflammatory and autoimmune diseases, and overall good treatment response and prognosis.

P094 “Neonatal lupus”: a unique name for very different realities

Abstract Background Neonatal lupus is a rare condition linked to the maternal-fetal transmission of maternal anti-SSA and/or anti-SSB antibodies, more rarely anti-U1-RNP. The most frequent clinical manifestations are cardiac and cutaneous, more rarely hematological (thrombocytopenia, leuco-neutropenia), hepatic (cholestasis), neurological (spastic paresis, lymphocytic meningitis) or renal. We report two observations of neonatal lupus: a classic form, and a rare form. Observations First case: A female newborn, premature of 37 weeks, from a first-degree consanguineous marriage, having a mother followed for systemic lupus erythematosus, with poor therapeutic compliance, presented at H1 of life with neonatal respiratory distress. The clinical examination revealed severe bradycardia at 67 Bpm. The electrocardiogram showed complete atrioventricular block, with a moderate pericarditis on the echocardiography, minimal tricuspid insufficiency, interatrial communication, and a 6 mm foramen oval with LR shunt. The immunological test had objectified positive antinuclear, anti-SSA and anti-SSB antibodies. An implementation of a pacemaker with inter-atrial communication ligation were performed successfully. The evolution was marked by the appearance of a malar erythema with generalized lesions of discoid lupus at the age of 14 months, treated with local corticosteroid therapy, with good outcomes. The control immunological workup was negative at 18 months. Second case: A 2-month-old boy from a non-consanguineous marriage with a mother followed for Sjögren's syndrome was admitted for a symptomatology dating back to birth marked by the appearance of diffuse petechial purpura. Clinically, the infant presented diffuse discoid macules throughout the body. The somatic examination, particularly cardiovascular, was normal. The biological workup showed haemolytic anaemia with a positive coombs test and severe thrombocytopenia. The electrocardiogram and echocardiography were normal. The immunological workup had objectified positive anti-SSA, anti-SSB and anti-nuclear antibodies. The infant was treated by oral corticosteroids (prednisolone) for 4 months, with good outcomes. The control immunological workup was negative at 6 months. Conclusion The clinical manifestations of neonatal lupus are polymorphic, and the only one that may expose to life threat is complete atrioventricular block. All mothers with known lupus or with positive anti-SSA autoantibodies should be monitored during pregnancy with repeated ultrasounds.

Lupus Erythematosus Tumidus: Clinical and Pathological Features in a Series of 20 Patients.

We sought to assess the clinicopathologic/immunophenotypical features in patients with lupus erythematosus tumidus (LET). All skin biopsies diagnosed as LET in 16 years were retrieved from our pathology laboratory. Clinical charts were reviewed and immunohistochemical markers were performed. Subpopulations of cells in the infiltrates were studied, as well as the number/distribution of plasmacytoid dendritic cells (PDC), which were compared with two control groups: normal skin and discoid lupus erythematosus. Direct immunofluorescence was performed when available. We found 20 patients (11 men and 9 women; mean age 43.5 years); the mean evolution previous to diagnosis was 20.3 months. They all had erythematous, nonscarring urticarial-like plaques: 8 in the head region only, 8 in trunk/limbs only; both segments were affected in 2 patients; topography was unknown in 2. Except for 1 patient, no one developed systemic lupus erythematosus. A dense perivascular/periadnexal superficial-to-deep lymphocytic infiltrate and stromal mucin deposition were characterized histopathologically; interphase changes were absent. Immunophenotype supported an inflammatory profile. The differential count of CD123 + PDC in 10/20 cases of LET (n = 1180) was notably higher than 5 cases of discoid lupus erythematosus (n = 419) and 5 cases of normal skin (n = 38). No immune deposits were found in 2 cases. LET is a rare, peculiar form of cutaneous lupus erythematosus that only exceptionally evolves to systemic lupus erythematosus . Its clinical-pathologic/immunophenotypical features are very characteristic. The amount of CD123 + PDC is a very helpful feature among the criteria for its diagnosis and seems to be relevant in its pathogenesis.

Successional occurrence of two papulosquamous disorders in HIV positive patient: a rare case report

<p class="abstract">Presentation of two papulosquamous disorders in a same individual is rare condition till date. Independently, psoriasis and Lichen planus (LP) are common inflammatory skin conditions affecting around 2-3% and 1% of HIV (Human immune deficiency) positive population respectively. As reviewed in the literature, psoriasis may be independently associated with other autoimmune conditions like vitiligo, alopecia areata, lichen planus, and discoid lupus erythematosus. In this article, we presented a case report of a HIV seropositive patient who suffered from psoriasis and lichen planus. The coexistence of psoriasis and lichen planus in one individual is rare and underreported in literature. Psoriasis or lichen planus may be the presenting feature of HIV infection and tends to be more severe, to have atypical presentations. Psoriasis and lichen planus can be coexistent or successionally appear one after other in one individual though rare presentation. High index of suspicion is always required while dealing with papulosquamous lesions in PLHIV.</p><p> </p>

Assessment of Serum Level of CXCL9 and CXCL10 in Cutaneous versus Systemic Lupus Erythematosus

Abstract Introduction: Lupus erythematosus has been a chronic inflammatory illness where chemokines play a great role in its pathogenesis. CXCL9 and CXCL10 are chemokines that were researched in a variety of inflammatory skin disorders for their crucial role in immune responses. Aim of the Work: To compare CXCL9 and CXCL10 serum levels in patients suffering from cutaneous versus systemic lupus erythematosus. Patients and Methods: The forty-five Egyptian patients in this case-control research were collected from the University Hospital's outpatient clinic between October 2018 and June 2019. Two groups of patients were established: DLE Group (Fifteen patients), and SLE group (Thirty patients) and forty control persons. Five ml of blood were obtained from all patients for assessment of serum CXCL9 and CXCL10 by enzme-linked immunosorbemt assay (ELISA) method. Results: When comparing patients with DLE and SLE to controls, our findings demonstrated highly statistically considerable increases in CXCL9 and CXCLl0 serum levels. Moreover, patients having SLE had a highly statistically considerable rise in both CXCL9 and CXCLl0 serum levels when compared to DLE patients. Meanwhile, when comparing SLE patients having active disease to those having inactive disease, there was a statistically significant rise in CXCL9 and CXCLl0 serum levels. Conclusion: The chemokines CXCL9 and CXCL10 may have had an etiopathogenesis role in SLE and DLE as they are increased in both DLE and SLE patients. In addition, CXCL10 levels in the serum could be used as a stand-alone biomarker for SLE activity. Keywords: Systemic lupus erythematosus, discoid lupus erythematosus, CXCL9, CXCL10.

The role of interleukin-17 (IL-17) in the pathogenesis of discoid lupus erythematosus and lichen planopilaris: is immunohistochemistry for IL-17 a promising way to differentiate these entities?

Interleukin-17 (IL-17) is a pro-inflammatory mediator which its excess secretion by immune cells is found in many chronic autoimmune diseases. This survey is aimed to compare the amount and pattern of distribution of IL-17 positive cells in lichen planopilaris (LPP) and discoid lupus erythematosus (DLE) which are of the most frequent causes of primary cicatricial alopecia (CA). Biopsies of lesional scalp skin from adult LPP (n = 30), DLE patients (n = 19), and control scalp skin (n = 18) were analyzed by immunohistochemistry (IHC) method using rabbit polyclonal antibody against IL-17. Cells stained positive for IL-17 and their pattern of distribution were assessed and compared between these groups. The mean of IL-17 positive cell counts per high power field (HPF) in both LPP and DLE groups was significantly higher in comparison with the control group (both p < .0001). The LPP group had higher values of IL-17 positive cell counts per HPF (47.56 ± 13.37) compared to the DLE group (22.21 ± 11.06) (p < .0001). More than 30 IL-17 positive cell counts in IHC have a sensitivity of 90% and a specificity of 78% for differentiating LPP from DLE. Our findings suggest that IL-17 is effective in the pathogenesis of DLE and LPP and its role is more prominent in LPP. IL-17 positive cells in IHC can distinguish DLE from LPP with satisfactory sensitivity and specificity.

Diverse molecular signatures observed in patients with cutaneous lupus erythematosus

British Journal of DermatologyVolume 185, Issue 3 p. e147-e147 Plain Language Summary Diverse molecular signatures observed in patients with cutaneous lupus erythematosus First published: 02 September 2021 https://doi.org/10.1111/bjd.20612AboutPDF ToolsRequest permissionExport citationAdd to favoritesTrack citation ShareShare Give accessShare full text accessShare full-text accessPlease review our Terms and Conditions of Use and check box below to share full-text version of article.I have read and accept the Wiley Online Library Terms and Conditions of UseShareable LinkUse the link below to share a full-text version of this article with your friends and colleagues. Learn more.Copy URL Share a linkShare onFacebookTwitterLinked InRedditWechat Abstract Linked Article: Zhu et al. Br J Dermatol 2021; 185:563–572. Cutaneous lupus erythematosus (CLE) is an autoimmune connective tissue disease affecting the skin. It has been estimated there are approximately 4·0 patients with the condition per 100,000 people. It affects more women than men and more African Americans than other ethnicities. CLE is a clinically diverse disease and can be divided into several subtypes including subacute CLE, discoid lupus erythematosus and lupus erythematosus tumidus. Although CLE can have different clinical presentations, patients largely receive the same initial treatments. This study was conducted in Dallas, Texas, USA and aimed to assess the molecular diversity found in patients with CLE. Blood samples were collected from a racially and ethnically diverse group of patients with CLE (n = 62) and gene expression was then studied using RNA sequencing. Analysis of data revealed that there were six unique subsets or groups of patients with CLE. The demographics and clinical features of these subsets were compared. It was found that two mostly non-African American and subacute CLE groups had inflammation and neutrophil signatures. Three clusters of predominantly African American patients and patients with discoid lupus erythematosus had increased expression of genes that related to T cells. This study shows that the molecular diversity of patients with CLE may reveal greater variation in CLE than previously recognized from just the clinical presentation of the disease. Future studies to better understand this molecular diversity in CLE can aid in the development of more targeted treatments for these different subsets of patients with CLE. Volume185, Issue3September 2021Pages e147-e147 RelatedInformation

Pili Torti: A Feature of Numerous Congenital and Acquired Conditions.

Pili torti is a rare condition characterized by the presence of the hair shaft, which is flattened at irregular intervals and twisted 180° along its long axis. It is a form of hair shaft disorder with increased fragility. The condition is classified into inherited and acquired. Inherited forms may be either isolated or associated with numerous genetic diseases or syndromes (e.g., Menkes disease, Björnstad syndrome, Netherton syndrome, and Bazex-Dupré-Christol syndrome). Moreover, pili torti may be a feature of various ectodermal dysplasias (such as Rapp-Hodgkin syndrome and Ankyloblepharon-ectodermal defects-cleft lip/palate syndrome). Acquired pili torti was described in numerous forms of alopecia (e.g., lichen planopilaris, discoid lupus erythematosus, dissecting cellulitis, folliculitis decalvans, alopecia areata) as well as neoplastic and systemic diseases (such as cutaneous T-cell lymphoma, scalp metastasis of breast cancer, anorexia nervosa, malnutrition, cataracts, and chronic graft-vs.-host disease). The condition may also be induced by several drugs (epidermal growth factor receptor inhibitors, oral retinoids, sodium valproate, and carbamide perhydrate). The diagnosis of pili torti is based on trichoscopic or microscopic examination. As pili torti is a marker of numerous congenital and acquired disorders, in every case, the search for the signs of underlying conditions is recommended.

Clinical profile of cutaneous manifestations of connective tissue diseases in North-East India

&lt;p class="abstract"&gt;&lt;strong&gt;Background:&lt;/strong&gt; Connective tissue diseases (CTDs) are a heterogeneous group of autoimmune disorders having overlapping clinical features. Skin is often involved and it may be the earliest sign of the disease. This study highlighted the various cutaneous manifestations of common CTDs.&lt;/p&gt;&lt;p class="abstract"&gt;&lt;strong&gt;Methods:&lt;/strong&gt; A hospital-based cross-sectional study was carried out for a period of two years in 83 patients with CTDs in dermatology OPD, RIMS, Imphal. Detailed history taking, examination and relevant serological tests were performed.&lt;strong&gt;&lt;/strong&gt;&lt;/p&gt;&lt;p class="abstract"&gt;&lt;strong&gt;Results:&lt;/strong&gt; The mean age was 39.78±17.29 years with female to male ratio of 4.5:1. Majority of the patients had lupus erythematosus (LE) (N=45) followed by systemic sclerosis (SSc) (N=25), rheumatoid arthritis (RA) (N=6), mixed connective tissue disease (MCTD) (N=4) and morphea (N=3). The most common presentation was raised skin lesions (45.8%) followed by Raynaud’s phenomenon (36.1%), photosensitivity (27.7%), skin tightness (26.5%) and joint pain (19.3%). Among LE patients, chronic cutaneous lupus erythematosus (CCLE) was the commonest variant and localised discoid lupus erythematosus (DLE) (22.9%) was the commonest presentation followed by malar rash and annular subacute lupus erythematosus (SCLE). Skin induration, microstomia and sclerodactyly were seen in most patients of SSc. Antinuclear antibodies were positive in 89.1% of patients. Anti-dsDNA and anti-Sm antibodies were positive in 62.2% and 33.3% of LE patients, anti-Scl 70 antibody was positive in 68% of SSc patients.&lt;/p&gt;&lt;p class="abstract"&gt;&lt;strong&gt;Conclusions:&lt;/strong&gt; CTDs are rare but potentially life-threatening. Proper understanding of the spectrum of cutaneous manifestations of CTDs is therefore necessary for early diagnosis and efficient management.&lt;/p&gt;

25656 Vulvar discoid lupus erythematosus: An unusual site for cutaneous lupus erythematosus

A 46-year-old woman presented with a 1-month history of a pruritic rash on trunk and face. On examination, she had well-defined erythematous scaly thin plaques photodistributed on the face, chest, ears, and neck. Biopsy demonstrated an interface dermatitis with increased dermal mucin. Laboratory evaluation was remarkable for a positive ANA 1:1280, but negative Ro/SS-A and La/SS-B antibodies. She was diagnosed with subacute cutaneous lupus erythematosus on the basis of clinical-pathologic findings. Tobacco cessation and strict sun protection were recommended, and she was prescribed hydroxychloroquine 200 mg twice daily and topical triamcinolone ointment. She was lost to follow-up during the COVID pandemic but was seen 6 months later with a persistent painful eruption of the vulva of several months’ duration. The patient had been hospitalized for this eruption and surgical debridement was performed which revealed a nonspecific neutrophilic infiltrate and tissue necrosis. Immunohistochemistry stain was negative for herpesvirus. She was treated with intravenous antibiotics and referred back to us. Upon her return visit, she had stopped smoking but was only taking hydroxychloroquine 200 mg daily. On examination, she had scarred erythematous patches on the labia minora and inguinal folds. Biopsy demonstrated a vacuolar interface dermatitis with superficial epidermal necrosis, dermal edema, and superficial and deep perivascular and periappendageal lymphoplasmacytic inflammation, favoring a diagnosis of discoid lupus erythematosus. We recommended increasing the hydroxychloroquine to 200 mg twice daily and continuing topical triamcinolone ointment.

Guideline for the diagnosis, treatment and long-term management of cutaneous lupus erythematosus

Cutaneous lupus erythematosus (CLE) is an inflammatory, autoimmune disease encompassing a broad spectrum of subtypes including acute, subacute, chronic and intermittent CLE. Among these, chronic CLE can be further classified into several subclasses of lupus erythematosus (LE) such as discoid LE, verrucous LE, LE profundus, chilblain LE and Blaschko linear LE. To provide all dermatologists and rheumatologists with a practical guideline for the diagnosis, treatment and long-term management of CLE, this evidence- and consensus-based guideline was developed following the checklist established by the international Reporting Items for Practice Guidelines in Healthcare (RIGHT) Working Group and was registered at the International Practice Guideline Registry Platform. With the joint efforts of the Asian Dermatological Association (ADA), the Asian Academy of Dermatology and Venereology (AADV) and the Lupus Erythematosus Research Center of Chinese Society of Dermatology (CSD), a total of 25 dermatologists, 7 rheumatologists, one research scientist on lupus and 2 methodologists, from 16 countries/regions in Asia, America and Europe, participated in the development of this guideline. All recommendations were agreed on by at least 80% of the 32 voting physicians. As a consensus, diagnosis of CLE is mainly based on the evaluation of clinical and histopathological manifestations, with an exclusion of SLE by assessment of systemic involvement. For localized CLE lesions, topical corticosteroids and topical calcineurin inhibitors are first-line treatment. For widespread or severe CLE lesions and (or) cases resistant to topical treatment, systemic treatment including antimalarials and (or) short-term corticosteroids can be added. Notably, antimalarials are the first-line systemic treatment for all types of CLE, and can also be used in pregnant patients and pediatric patients. Second-line choices include thalidomide, retinoids, dapsone and MTX, whereas MMF is third-line treatment. Finally, pulsed-dye laser or surgery can be added as fourth-line treatment for localized, refractory lesions of CCLE in cosmetically unacceptable areas, whereas belimumab may be used as fourth-line treatment for widespread CLE lesions in patients with active SLE, or recurrence of ACLE during tapering of corticosteroids. As for management of the disease, patient education and a long-term follow-up are necessary. Disease activity, damage of skin and other organs, quality of life, comorbidities and possible adverse events are suggested to be assessed in every follow-up visit, when appropriate.

Male sex, discoid lupus erythematosus, and lower limb involvement are associated with systemic lupus in lupus panniculitis patients: A multicenter case series of 74 patients

To the Editor: Lupus erythematosus panniculitis (LEP) occurs in 1% to 3% of patients with cutaneous lupus erythematosus 1 Requena L. Sánchez Yus E. Panniculitis. Part II. Mostly lobular panniculitis. J Am Acad Dermatol. 2001; 45 (quiz 362-364): 325-361 Abstract Full Text Full Text PDF PubMed Scopus (390) Google Scholar ,2 Sánchez N.P. Peters M.S. Winkelmann R.K. The histopathology of lupus erythematosus panniculitis. J Am Acad Dermatol. 1981; 5: 673-680 Abstract Full Text PDF PubMed Scopus (119) Google Scholar and is characterized by recurrent nodules or plaques that can evolve to lipoatrophy 1 Requena L. Sánchez Yus E. Panniculitis. Part II. Mostly lobular panniculitis. J Am Acad Dermatol. 2001; 45 (quiz 362-364): 325-361 Abstract Full Text Full Text PDF PubMed Scopus (390) Google Scholar ,3 Rangel L.K. Villa-Ruiz C. Lo K. et al. Clinical characteristics of lupus erythematosus panniculitis/profundus: a retrospective review of 61 patients. JAMA Dermatol. 2020; 156: 1264-1266 Crossref PubMed Scopus (3) Google Scholar and impair quality of life. 4 Ogunsanya M.E. Cho S.K. Hudson A. Chong B.F. Validation and reliability of a disease-specific quality-of-life measure in patients with cutaneous lupus erythematosus. Br J Dermatol. 2019; 180: 1430-1437 Crossref PubMed Scopus (10) Google Scholar In a recent study of 61 patients with LEP, the proportion of systemic lupus erythematosus (SLE) was 21%. 3 Rangel L.K. Villa-Ruiz C. Lo K. et al. Clinical characteristics of lupus erythematosus panniculitis/profundus: a retrospective review of 61 patients. JAMA Dermatol. 2020; 156: 1264-1266 Crossref PubMed Scopus (3) Google Scholar Little is known about the differences between LEP with or without SLE 5 Petri M. Orbai A.M. Alarcón G.S. et al. Derivation and validation of the Systemic Lupus International Collaborating Clinics classification criteria for systemic lupus erythematosus. Arthritis Rheum. 2012; 64: 2677-2686 Crossref PubMed Scopus (1) Google Scholar and baseline features associated with the occurrence of sequelae.

S2k guideline: Diagnosis and management of cutaneous lupus erythematosus - Part1: Classification, diagnosis, prevention, activity scores.

S2k guideline: Diagnosis and management of cutaneous lupus erythematosus - Part1: Classification, diagnosis, prevention, activity scores.

Hydroxychloroquine dose tapering or discontinuation in cutaneous lupus erythematosus after remission: A retrospective multicenter cohort study of 56 patients

Hydroxychloroquine dose tapering or discontinuation in cutaneous lupus erythematosus after remission: A retrospective multicenter cohort study of 56 patients