Sclerodermic lep slep, first coined by marzano in 2005 to describe this entity, has only been noted in 4 patients. Do you know how to distinguish sle from other conditions with similar clinical characteristics. Dle lesions begin as welldemarcated erythematous macules or papules with a scaly surface, and frequently evolve into larger coinshaped plaques. Clinically, the lesions appear as diskshaped plaques surmounted by a. Lupus erythematosus is a chronic inflammatory autoimmune disease with a wide range of clinical manifestations ranging from an indolent chronic cutaneous form to a severe potentially lifethreatening disease, systemic lupus erythematosus discoid lupus erythematosus is a subphenotype of chronic cutaneous lupus erythematosus, characterised by scaly diskshaped plaques which may be localised. Discoid lupus erythematosus is an uncommon skin rash, usually made worse by exposure to sunlight. Lesions are often localized to the scalp and can result in permanent scarring, disfiguration, and irreversible alopecia.
It does not progress to systemic lupus erythematosus sle in dogs. The skin around the nose may also look abnormal, and rarely. Also discoid lupus erythematosus can progress to systemic lupus erythematosus. The history of lupus erythematosus is divided into three categories. Discoid lupus erythematosus successfully treated by photodynamic therapy. However, approximately 10 percent of people who have discoid lupus may develop sle systemic lupus erythematosus. Discoid lupus causes, symptoms and treatment patient. This condition causes a severe rash that tends to get worse when exposed to sunlight. Lupus erythematosus le is a chronic, autoimmune disease that includes a broad spectrum of symptoms. Discoid lupus erythematosus is the most common type of chronic cutaneous lupus ccle, an autoimmune skin condition on the lupus erythematosus spectrum of illnesses.
Dermoscopic features of discoid lupus erythematosus dle depend on the stage of the lesions. It is characterised by persistent scaly, disklike plaques on scalp, face and ears that may cause pigmentary changes, scarring and hair loss. Affected horses develop areas of patchy erythema, crusting alopecia, and scaling on the face, ears, and neck. Risk of systemic lupus erythematosus is approximately 5%.
Le is included among the so called connective tissue diseases and is divided into one systemic form sle and one cutaneous form cle. It is classified as either localised, affecting skin above the neck only, or generalised, affecting above and below the neck. The skin is involved in up to 85% of systemic lupus erythematosus sle cases and may be the only organ involved in cutaneous lupus erythematosus cle. Early recognition and treatment improves the prognosis. Discoid lupus erythematosus dle is an uncommon autoimmune disease of the basal cell layer of the skin. The diagnosis and treatment of systemic lupus erythematosus. Discoid lupus can be localised to affect a small area of skin, or may be more widespread. Discoid lupus is an uncommon but longlasting chronic skin rash, which is usually made worse by exposure to sunlight it is photosensitive. Discoid lupus erythematosus in the nigerians jacyk. Guideline on clinical investigation of medicinal products. Discoid lupus erythematosus is a chronic dermatological disease that can lead to scarring, hair loss, and hyperpigmentation changes in skin if it is not treated early and promptly. The term is also used for localized cutaneous lesions such as those seen in discoid lupus erythematosus dle, lupus erythematosus profundus and subacute.
It occurs in humans and cats, more frequently occurring in dogs. Cutaneous lupus erythematosus cle is a common manifestation among systemic lupus patients. Importance discoid lupus erythematosus dle is a chronic variant of cutaneous lupus erythematosus, an autoimmune inflammatory disorder of the skin. Discoid lupus erythematosus dle is a skin condition of dogs. Discoid lupus discoid lupus erythematosus is a chronic autoimmune disease affecting the skin. What is discoid lupus erythematosus lupus erythematosus le is a group of diverse, persistent inflammatory autoimmune diseases and often affects the skin. Dle most commonly occurs on the head and is characterized by welldefined inflammatory plaques that evolve into atrophic, disfiguring scars. Discoid lupus erythematosus dle is a chronic photosensitive skin eruption which can be either localised or widespread. Discoid lupus erythematosus is a rare skin disease in horses that is believed to be a variant of systemic lupus erythematosus.
New horizons in the genetic etiology of systemic lupus. Draft guideline systemic lupus erythematosus sle european. Systemic lupus erythematosus sle is an autoimmune disease with a prevalence of 36. Cutaneous manifestations of systemic lupus erythematosus. Patients with chronic discoid lupus erythematosus constituted 046% of all out. Discoid lupus erythematosus dle is the most common chronic form of cutaneous lupus. Treatment of alopecia in chronic cutaneous lupus erythematosus. Results of a detailed clinical and laboratory study of 37 nigerian patients with chronic discoid lupus erythematosus are presented. Discoid lupus erythematosus is an autoimmune disease which occurs in genetically predisposed individuals. Omim 152700 is a complex autoimmune disease not only from a clinical standpoint but also from genetic. Systemic lupus erythematosus sle is a multiorgan autoimmune disease of unknown etiology that can have many clinical manifestations table 1.
Dermoscopy of discoid lupus erythematosus request pdf. While the face, trunk and extremities are frequently affected, eyelid involvement is uncommon and often presents as a diagnostic problem. At one end of the range is systemic lupus erythematosus, which can damage internal organs, whilst right at the other end of the range is discoid lupus erythematosus, which is confined to the skin and does not cause general ill health. Lupus uk is the national charity caring for those with systemic lupus erythematosus sle and discoid lupus erythematosus dle, supporting people as they develop the symptoms prior to diagnosis and those already diagnosed. Discoid lupus erythematosus dle is a chronic inflammatory erythematous skin disease that can be triggered by several factors. It gets its name from the coinshaped lesions it produces. It is confined to the skin and does not cause any systemic symptoms. The lesions are typically chronic scaly plaques on the face, scalp and ears.
Lupus erythematosus is a collection of autoimmune diseases in which the human immune system becomes hyperactive and attacks healthy tissues. Understanding discoid or cutaneous lupus erythematosus. Dogs with dle develop crusting and scabbing of the skin, most commonly starting around the nose, as well as a loss of skin pigmentation in the affected area. Pathology of discoid lupus erythematosus dr sampurna roy md. The discoid lupus erythematosus treatment includes sunscreens, steroids and antimalarial medications. In this case report, the authors describe a variant of discoid lupus erythematosus dle limited to the skin in a 9yearold chinese crested dog. Discoid lupus erythematosus dle and subacute cutaneous lupus erythematosus scle are variants of cutaneous lupus that may occur independently or as manifestations of systemic lupus erythematosus.
Sle patients were consecutively enrolled in a cross sectional study. Discoid cutaneous lupus erythematosus vca animal hospital. Discoid lupus erythematosus dle is one of several rashes that can occur in lupus. The discoloration can be accompanied by ulcers and bleeding.
Symptoms of these diseases can affect many different body systems, including joints, skin, kidneys, blood cells, heart, and lungs. Lupus erythematosus le is a chronic, autoimmune, multisystem disease that displays many diverse symptoms in which localized cutaneous le cle is on. Discoid or cutaneous lupus refers to symptoms affecting the skin. Treatment in sle aims at remission or low disease activity and. Discoid lupus erythematosus dle is a chronic form of cutaneous lupus, which can cause scarring. Discoid lupus erythematosus dle, also known as cutaneous lupus erythematosus, is an autoimmune disease that affects the skin, in which the bodys own immune system is activated to attack the body. Systemic lupus erythematosus sle, is the most common type of lupus.
Discoid rash raised erythematous patches with keratotic scaling, follicular plugging, and atrophic scarring 3. Many drugs have been used to treat this disease and some such as thalidomide, cyclophosphamide and azathioprine are potentially toxic. The dog had a 9month history of progressive skin disease characterized by annular to polycyclic, hyperpigmented, scaly to erythematous lesions. Discoid lupus erythematosus in dogs dr robert hilton bvschons macvsc canine medicine cert. Early diagnosis and treatment of discoid lupus erythematosus. Cutaneous lupus erythematosus in a linear configuration is rare, especially in children.
You can help by taking up membership for more information contact. Clinical practice guideline on systemic lupus erythematosus. The term lupus erythematosus is applied to a range of related disorders. It has a prolonged course and can have a considerable effect on quality of life. It typically causes a loss of color in the hairless, moist part of the nose. There are no fda approved therapies for cle, and these. Discoid lupus erythematosus an overview sciencedirect. Linear cutaneous lupus erythematosus following the lines. Discoid lupus erythematosus involving the eyelids article in journal of the european academy of dermatology and venereology 191. Sle can also have skin symptoms, but it appears that the two are either separate diseases or dle is a mild form of sle. Discoid lupus erythematosus dle is a benign, autoimmune disorder of the skin.
Dle discoid lupus collie nose what is discoid lupus. Physical activity and sedentary behavior in patients with. To develop new classification criteria for systemic lupus erythematosus sle jointly supported by the. Systemic lupus erythematosus sle is the prototypic multisystem autoimmune disorder with a broad spectrum of clinical presentations. The clinical course is variable, with a broad spectrum of organ manifestations.
Pdf cutaneous lupus erythematosus issues in diagnosis. The patient also had conconcomitant discoid lupus erythematosus dle with a similar pattern sclerodermalike fibrosis, ie, sclerodermic dle. The diagnosis is usually made by clinical examination. Lupus is the latin word for wolf and has been used to name various skin diseases at least since the 10 th century. The relationship between discoid and systemic lupus. Hippocrates was the first to document symptoms consistent with that of lupus erythematosus in the year 400 bc. Immunoglobulins are found in the skin in this autoimmune disease. Katarzyna gilekseibert, md abstract systemic lupus erythematosus sle is a chronic, compli. Many physicians have studied and added to the current day knowledge of lupus erythematosus.
At one end of the range is systemic lupus erythematosus, which can damage internal organs, whilst right at the other end of the range is discoid lupus. Discoid lupus erythematosus british association of. This form of lupus is typically limited to the skin. Discoid lupus erythematosus dle is the most common form of cutaneous lupus erythematosus. Turan e, sinem bagci i, turgut erdemir a, salih gurel m. Discoid lupus erythematosus dle is a chronic inflammatory condition of the skin. Rheumatologists sometimes use specific criteria cdcpdf pdf 510kbexternal to classify sle for research purposes. Previous research on cutaneous lupus erythematosus lesions has been directed at examining the relationship between the scarring lesions of discoid lupus erythematosus dle and systemic lupus erythematosus sle and the pathogenesis of the lesions of cutaneous lupus erythematosus. Our objective was to update the eular recommendations for the management of systemic lupus erythematosus sle, based on emerging new evidence. Discoid lupus erythematosus of the eyelids harvey siy uy, md introduction. It presents with red, inflamed, coinshaped patches of skin with a scaling and crusty appearance, most often on the scalp, cheeks, and ears.
Rosacea is another skin disease that causes facial redness and tenderne. Sle is an autoimmune disease in which the immune system attacks its own tissues, causing widespread inflammation and tissue damage in the affected organs. Discoid lupus erythematosus symptoms, diagnosis and. Systemic lupus erythematosus sle, a multisystem autoimmune disorder occurring predominantly in women of reproductive age, has diverse clinical manifestations and is often difficult to diagnose. Discoid lupus is also called discoid lupus erythematosus dle. The most common and severe form is systemic lupus erythematosus. General management of systemic lupus erythematosus.
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