ABSTRACT
Systemic Lupus Erythematosus is a chronic inflammatory disease with multifactorial etiology. Although clinical manifestations are varied, the skin is an important target-organ, which contributes to the inclusion of skin lesions in 4 out of the 17 new criteria for the diagnosis of the disease, according to the Systemic Lupus International Collaborating Clinics. The cutaneous manifestations of lupus are pleomorphic. Depending on their clinical characteristics, they can be classified into Acute Cutaneous Lupus Erythematosus, Subacute Cutaneous Lupus Erythematosus, Chronic Cutaneous Lupus Erythematosus and Intermittent Cutaneous Lupus Erythematosus. Treatment is based on preventive measures, reversal of inflammation, prevention of damage to target organs and relief of adverse events due to pharmacological therapy. The most commonly used treatment options are topical, systemic and surgical treatment, as well as phototherapy. The correct handling of the cases depends on a careful evaluation of the morphology of the lesions and the patient's general status, always taking into consideration not only the benefits but also the side effects of each therapeutic proposal.
Subject(s)
Female , Humans , Male , Lupus Erythematosus, Cutaneous/pathology , Lupus Erythematosus, Cutaneous/therapy , Lupus Erythematosus, Systemic/pathology , Lupus Erythematosus, Systemic/therapy , Risk Factors , Skin/pathologySubject(s)
Female , Adult , Humans , Skin Diseases, Papulosquamous/diagnosis , Skin Diseases, Papulosquamous/therapy , Lupus Erythematosus, Cutaneous/diagnosis , Lupus Erythematosus, Cutaneous/therapy , Sunscreening Agents/therapeutic use , Hydroxychloroquine/therapeutic use , Prednisone/therapeutic use , Treatment OutcomeABSTRACT
Lupus tumidus is a rare sub-type of chronic cutaneous lupus erythematosus characterized by dermal plaques in which excessive mucin accumulates early in disease process. We report a middle aged women having succulent, edematous and persistent plaque over her face for five years that was not responding to various empirical treatments offered to her. Finally, on clinico-pathological basis, it was diagnosed as a case of tumid lupus erythematosus [TLE] and she responded satisfactorily to the treatment regimen including oral steroids, chloroquine and application of sun screen
Subject(s)
Humans , Female , Lupus Erythematosus, Cutaneous/therapy , Antirheumatic Agents , Chloroquine , Methylprednisolone , Chronic Disease , Treatment OutcomeABSTRACT
Relatamos o caso clínico de um recém-nascido que apresentava lesöes eritêmato-escamosas anulares acomentendo a regiäo frontal, evoluindo posteriormente para a área periorbitária, associadas a um bloqueio cardíaco do ramo direito. O diagnóstico foi de lúpus eritematoso neonatal, doença auto-imune, causada pela transferência transplacentária de anticorpos maternos anti-Ro (SSA), cuja apresentaçäo clínica pode se caracterizar por lesöes cutâneas do lúpus, bloqueio cardíaco congênito, doença hepática colestática e trombocitopenia. O recém-nascido evoluiucom regressäo completa das lesöes cutâneas após um período de seis meses, sendo instituído o uso de fotoprotetores tópicos e acompanhamento ambulatorial pela Cardiologia.
Subject(s)
Humans , Infant, Newborn , Adrenal Cortex Hormones , Heart Block/complications , Heart Block/genetics , Lupus Erythematosus, Cutaneous/diagnosis , Lupus Erythematosus, Cutaneous/etiology , Lupus Erythematosus, Cutaneous/therapy , Lupus Erythematosus, Systemic/diagnosis , Lupus Erythematosus, Systemic/etiology , Lupus Erythematosus, Systemic/therapy , Lupus Erythematosus, DiscoidSubject(s)
Humans , Female , Pregnancy , Infant, Newborn , Infant , Infant, Newborn, Diseases/diagnosis , Lupus Erythematosus, Cutaneous/congenital , Contraceptives, Oral/adverse effects , Lupus Erythematosus, Cutaneous/diagnosis , Lupus Erythematosus, Cutaneous/therapy , Pregnancy Complications/diagnosisABSTRACT
O lúpus eritematoso cutâneo subagudo (LECS) é observado em cerca de 10 por cento dos pacientes com LE e foi caracterizado em 1979, por Sontheimer. A fotossensibilidade é marcante e o curso clínico relativamente benigno com febre, astenia e envolvimento do sistema nervoso central. O comprometimento renal é raro e quando ocorre é de forma discreta. O tratmento na maioria dos pacientes consiste de protetores solares, corticosteróides tópicos e antimaláricos.
Subacute cutaneous lupus erythematosus (SCLE) is in about 10% of patients with LE and it was characterized, in 1979, by Sontheimer. This subset exhibits prominent photosensitivity and relatively benign course. Fever, malaise and central nervous system involvement occur. Renal disease is mild and infrequent. SCLE condition in most patients is controlled with sunscreens, topical corticosteroid and antimalarial drugs.
Subject(s)
Humans , Male , Female , Lupus Erythematosus, Cutaneous/diagnosis , Lupus Erythematosus, Cutaneous/physiopathology , Lupus Erythematosus, Cutaneous/immunology , Lupus Erythematosus, Cutaneous/therapy , Autoimmunity , Fluorescent Antibody TechniqueABSTRACT
Os autores relatam um caso clínico de lúpus eritematoso neonatal (LEN) numa criança de três meses que apresentava lesöes cutâneas desde os 18 dias de vida. Além disso säo feitas consideraçöes quanto a etiopatogenia, aspectos clínicos, tratamento e prognóstico da síndrome
Subject(s)
Humans , Female , Infant, Newborn , Infant, Newborn , Lupus Erythematosus, Cutaneous/therapy , Lupus Erythematosus, Cutaneous/diagnosis , Signs and SymptomsABSTRACT
La historia y la literatura del lupus eritematoso vemos que es controversial. Los aspectos orales y dermatológicos de la enfermedad han sido descritos en forma más sencilla. La frecuencia y la importancia de los síntomas orales a la vez se presentan. El tratamiento todavía es discutido. Parece que el mejor tratamiento de los síntomas clínicos en ACTH y cortisona y algunos casos a la larga pueden curar. El tratamiento puede ser indefinido en algunos casos, otros curan solos
Subject(s)
Humans , Lupus Erythematosus, Cutaneous/physiopathology , Lupus Erythematosus, Cutaneous/therapyABSTRACT
Dentro del espectro del lupus cutáneo -agudo, subagudo y crónico- el lupus eritematoso cutáneo subagudo (LECS) se caracteriza por ser diseminado y no cicatrizal, con manifestaciones clínicas y evolutivas que le diferencian tanto del lupus discoide (LD) como del sistémico (LES). En un período de diez años, se registraron 19 pacientes con LECS; de ellos se estudiaron en forma completa 6, 4 mujeres y 2 hombres, con una edad promedio de 31 años, de raza blanca (entendiendo por tal aquellas pieles que frente a la exposición solar se broncean lenta o normalmente pero sin quemarse). Clínicamente todos presentaron placas eritematoescamosas en áreas fotoexpuestas, con predominio diferente de algunas de sus características: 1/6 presentó eritema en vespertilio, síndrome de Raynaud y/o alopecias. Todos tuvieron manifestaciones sistémicas: 2/6 neurológicas, 2/6 renales, coincidiendo ambas en un paciente. Los exámenes de laboratorio mostraron, en todos los pacientes, aumento de VES y gamaglobulinas y positividad de los anticuerpos antinucleares (ANA); en 4 se encontraron anticuerpos anti RO e hipocomplementemia. La histología mostró en todos los casos leve hiperortoqueratosis, discreta atrofia y degeneración basal por licuefacción de la unión dermoepidérmica. La inmunofluorescencia indirecta (IFI) reveló la banda lúpica característica. El plan terapéutico incluyó pantalla solar y antipalúdicos de síntesis. Concluimos que: 1)debe reconocerse al LECS como una entidad más dentro del espectro del lupus cutáneo, independiente, tanto en su forma clínica y de los hallazgos de laboratorio, así como en su evolución y pronóstico; 2)existe superposición con el LES: 3/6 de los pacientes de nuestra casuística cumplían con los criterios de la American Rheumatism Association (ARA), para el diagnóstico de LES; 3)la luz solar tiene un papel preponderante en la patogenia del LES, pues determina la expresión de neoantígenos tales como el RO/SS-A; 4)la hidroclorotiazida es capaz de desencadenarlo