Cutaneous manifestations of systemic lupus erythematosus in a tertiary referral center
- PMID: 20101308
- PMCID: PMC2807152
- DOI: 10.4103/0019-5154.53189
Cutaneous manifestations of systemic lupus erythematosus in a tertiary referral center
Abstract
Background: Systemic lupus erythematosus (SLE) is an autoimmune disease with multiorgan involvement. The skin is the second most commonly affected organ. SLE with skin lesions can produce considerable morbidity resulting from painful skin lesions, alopecia, disfigurement, etc. Skin lesions in patients with lupus may be specific (LE specific) or may be non specific (LE non specific). Acute cutaneous LE (Lupus specific) has a strong association with systemic disease and non-specific skin lesions always indicate disease activity for which patients present to rheumatologists and internists. Therefore, a thorough understanding of the cutaneous manifestations of SLE is essential for most efficient management.
Aims: The aims of this study were to evaluate the patterns and prevalence of skin lesions in patients with SLE and to assess the relationship between skin lesions and other systemic involvement.
Materials and methods: At the Department of Rheumatology and Clinical Immunology, IPGME&R in Kolkata, 150 patients with SLE fulfilling the clinical and laboratory criteria of the American Rheumatology Association (updated 1982) were examined and followed-up for cutaneous manifestations between January 2002 and January 2007.
Results: Skin lesions were important clinical features. About 45 patients (30%) presented with skin lesions although all patients had skin lesions during the follow-up period. Skin changes noted were as follows: Lupus specific lesions: malar rash in 120 patients (80%), photosensitive dermatitis in 75 patients (50%), generalized maculopapular rash in 40 patients (26.67%), discoid rash in 30 patients (20%), subacute cutaneous lupus erythematosus (SCLE) in 5 patients (3.34%), lupus profundus in 5 patients (3.34%). The lupus non-specific lesions were non-scarring alopecia in 130 patients (86.67%), oral ulcers in 85 patients (56.67%), vasculitic lesions in 50 patients (33.34%), bullous lesions in 15 patients (10%), Raynaud's phenomenon in 10 patients (6.67%), pyoderma gangrenosum in 2 patients (1.34%), erythema multiforme in 10 patients (6.67%), and nail fold infarcts in 2 patients (1.34%); however, mucosal discoid lupus, lichenoid discoid lupus, livedo reticularis, sclerodactyly, etc. were not detected. Patients having lupus-specific skin lesions e.g., malar rash were associated with systemic involvement, whereas those having lupus non-specific skin lesions were associated with disease flare.
Conclusions: Skin lesions in patients with SLE are important disease manifestations and proper understanding is essential for diagnosis and efficient management.
Keywords: Cutaneous manifestations; organ involvement; systemic lupus erythematosus.
Conflict of interest statement
Figures








Similar articles
-
Cutaneous manifestations of systemic lupus erythematosus.Br J Dermatol. 1996 Sep;135(3):355-62. Br J Dermatol. 1996. PMID: 8949425
-
Rowell Syndrome in Nigeria: Systemic Lupus Erythematosus Presenting as Recurrent Erythema Multiforme in a Young Woman.Acta Dermatovenerol Croat. 2019 Sep;27(3):200-201. Acta Dermatovenerol Croat. 2019. PMID: 31542069
-
The spectrum of cutaneous manifestations in lupus erythematosus--the Italian experience.Lupus. 2000;9(6):417-23. doi: 10.1191/096120300678828569. Lupus. 2000. PMID: 10981645
-
Cutaneous lupus erythematosus: issues in diagnosis and treatment.Am J Clin Dermatol. 2009;10(6):365-81. doi: 10.2165/11310780-000000000-00000. Am J Clin Dermatol. 2009. PMID: 19824738 Review.
-
Clinical course and prognosis of cutaneous lupus erythematosus.Clin Dermatol. 2004 Mar-Apr;22(2):121-4. doi: 10.1016/j.clindermatol.2003.12.018. Clin Dermatol. 2004. PMID: 15234012 Review.
Cited by
-
Cutaneous Manifestations of Systemic Lupus Erythematosus and Their Correlation With Cardiac Involvement.Cureus. 2024 Dec 27;16(12):e76478. doi: 10.7759/cureus.76478. eCollection 2024 Dec. Cureus. 2024. PMID: 39866976 Free PMC article. Review.
-
Understanding the disease burden and unmet needs among patients with cutaneous lupus erythematosus: A qualitative study.Int J Womens Dermatol. 2018 Apr 13;4(3):152-158. doi: 10.1016/j.ijwd.2018.01.002. eCollection 2018 Sep. Int J Womens Dermatol. 2018. PMID: 30175217 Free PMC article.
-
Demographic and clinical characteristics of cutaneous lupus erythematosus at a paediatric dermatology referral centre.Br J Dermatol. 2013 Aug;169(2):428-33. doi: 10.1111/bjd.12383. Br J Dermatol. 2013. PMID: 23601021 Free PMC article.
-
Pyoderma Gangrenosum as a Presenting Feature of Undifferentiated Spondyloarthropathy with Erosive Inflammatory Arthritis.Case Rep Rheumatol. 2020 Mar 26;2020:1848562. doi: 10.1155/2020/1848562. eCollection 2020. Case Rep Rheumatol. 2020. PMID: 32274238 Free PMC article.
-
Retiform Purpura with Overlying Bullae: Unusual Presentation of Systemic Lupus Erythematous in Children.Turk Arch Pediatr. 2021 Jul 1;56(4):403-404. doi: 10.5152/TurkArchPediatr.2021.21009. eCollection 2021 Jul. Turk Arch Pediatr. 2021. PMID: 35005741 Free PMC article. No abstract available.
References
-
- Cervera R, Khamashta MA, Font J, Sebastiani GD, Gil A, Lavilla P, et al. Systemic lupus erythematosus: Clinical and immunologic pattern of disease expression in a cohort of 1000 patients. Medicine. 1993;72:113–24. - PubMed
-
- McCauliffe DP. Cutaneous lupus erythematosus. Semin Cutan Med Surg. 2001;20:14–26. - PubMed
-
- O'Quinn SE, Cole J, Many H. Problems of disability in patients with chronic skin disease. Arch Dermatol. 1972;105:35–40. - PubMed
-
- Gilliam JN, Sontheimer RD. Skin manifestations of SLE. Clin Rheum Dis. 1982;8:207–18. - PubMed
-
- Font J, Bosch X, Ingelmo M, Herrero C, Bielsa I, Mascaró JM. Acquired icthyosis in a patient with SLE. Arch Dermatol. 1990;126:829. - PubMed
LinkOut - more resources
Full Text Sources