scholarly journals Cutaneous Manifestations of “Lupus”: Systemic Lupus Erythematosus and Beyond

2021 ◽  
Vol 2021 ◽  
pp. 1-19
Author(s):  
Elizabeth E. Cooper ◽  
Catherine E. Pisano ◽  
Samantha C. Shapiro
Keyword(s):  
Systemic Lupus Erythematosus ◽  
Lupus Erythematosus ◽  
Systemic Treatment ◽  
Treatment Options ◽  
Cutaneous Lupus Erythematosus ◽  
Laboratory Studies ◽  
Systemic Lupus ◽  
Cutaneous Manifestations ◽  
Distinct Disease ◽  
Cutaneous Lupus

Lupus, Latin for “wolf,” is a term used to describe many dermatologic conditions, some of which are related to underlying systemic lupus erythematosus, while others are distinct disease processes. Cutaneous lupus erythematosus includes a wide array of visible skin manifestations and can progress to systemic lupus erythematosus in some cases. Cutaneous lupus can be subdivided into three main categories: acute cutaneous lupus erythematosus, subacute cutaneous lupus erythematosus, and chronic cutaneous lupus erythematosus. Physical exam, laboratory studies, and histopathology enable differentiation of cutaneous lupus subtypes. This differentiation is paramount as the subtype of cutaneous lupus informs upon treatment, disease monitoring, and prognostication. This review outlines the different cutaneous manifestations of lupus erythematosus and provides an update on both topical and systemic treatment options for these patients. Other conditions that utilize the term “lupus” but are not cutaneous lupus erythematosus are also discussed.

scholarly journals Lenalidomide for refractory cutaneous manifestations of pediatric systemic lupus erythematosus

Lupus ◽  
2016 ◽  
Vol 26 (6) ◽  
pp. 646-649 ◽  
Author(s):  
E Y Wu ◽  
L E Schanberg ◽  
E C Wershba ◽  
C E Rabinovich
Keyword(s):  
Systemic Lupus Erythematosus ◽  
Lupus Erythematosus ◽  
Cutaneous Lupus Erythematosus ◽  
Retrospective Chart Review ◽  
Rank Test ◽  
Systemic Lupus ◽  
Cutaneous Manifestations ◽  
Prednisone Dose ◽  
Pediatric Systemic Lupus Erythematosus ◽  
Cutaneous Lupus

Objective Cutaneous manifestations of pediatric systemic lupus erythematosus cause significant morbidity. Lenalidomide, a thalidomide analogue, has shown promise treating cutaneous lupus erythematosus in adults. Our objective was to evaluate lenalidomide’s efficacy and safety in treating refractory cutaneous manifestations of pediatric systemic lupus erythematosus. Methods We performed a retrospective chart review of 10 adolescents who received lenalidomide for recalcitrant cutaneous lupus erythematosus. Information was gathered at drug initiation and 6-month follow-up. The Wilcoxon matched-pairs signed-rank test was used to assess change in quantitative parameters of disease activity. Results Nine subjects were girls and six were African-American. Indications for lenalidomide treatment included alopecia, nasal and oral ulcers, extensive malar rash, discoid lesions, bullous lesions, panniculitis, cutaneous vasculitis, and Raynaud’s phenomenon with digital ulcerations. Within 6 months, all patients demonstrated complete or near resolution based on physician report. Prednisone dose decreased from a mean 23.5 mg (SD± 13.3) to 12.25 mg (SD± 9.2) ( P= 0.008). Sedimentation rate decreased from a mean 29 mm/hour (SD± 31.5) to 17 mm/hour (SD± 18.1) ( P= 0.004). Lenalidomide was well tolerated. Conclusion Lenalidomide is an effective and safe treatment for a spectrum of dermatological conditions in pediatric systemic lupus erythematosus. Its use may allow a reduction in prednisone dose and decreased disfigurement. Prospective study is needed to clarify lenalidomide’s role in treating cutaneous manifestations of systemic lupus erythematosus.

scholarly journals A different kind of skin presentation in Systemic Lupus Erythematosus (SLE): A case report

2020 ◽  
Vol 4 (1) ◽  
pp. 42-46
Author(s):  
Huzairi Sani ◽  
Nada Syazana ◽  
Malek Faris Riza Feisal
Keyword(s):  
Systemic Lupus Erythematosus ◽  
Case Report ◽  
Lupus Erythematosus ◽  
Erythema Nodosum ◽  
Cutaneous Lupus Erythematosus ◽  
Systemic Lupus ◽  
Cutaneous Manifestations ◽  
Subcutaneous Nodules ◽  
The Face ◽  
Cutaneous Lupus

Erythema nodosum is a septal panniculitis which is a variant of chronic cutaneous lupus erythematosus (CCLE). It is further classified in the group of Lupus Erythematous Panniculitis (LEP).[1] The most frequent cutaneous manifestations include indurated plaques, subcutaneous nodules and sometimes ulcerations. The lesions occur predominantly on the face, upper arms, upper trunk, breasts, buttocks and thighs.[2] They occur most frequently in adult females and do not typically manifest cutaneously in Systemic Lupus Erythematosus (SLE).[3] In this case report, we discuss a young gentleman who presented with erythema nodosum as a cutaneous feature of SLE.         Keywords: Systemic lupus erythematosus, erythema nodosum, panniculitis, cutaneous lupus

scholarly journals Advancing understanding, diagnosis, and therapies for cutaneous lupus erythematosus within the broader context of systemic lupus erythematosus

F1000Research ◽  
2019 ◽  
Vol 8 ◽  
pp. 332 ◽  
Author(s):  
Kristen L. Chen ◽  
Rebecca L. Krain ◽  
Victoria P. Werth
Keyword(s):  
Systemic Lupus Erythematosus ◽  
Lupus Erythematosus ◽  
Treatment Options ◽  
Cutaneous Lupus Erythematosus ◽  
Systemic Lupus ◽  
Disease Heterogeneity ◽  
Adaptive Immune ◽  
The Us ◽  
New Treatment ◽  
Cutaneous Lupus

Cutaneous lupus erythematosus (CLE) is an autoimmune disease that can be associated with systemic lupus erythematosus (SLE) symptoms. The pathogenesis of both CLE and SLE is multifactorial, involving genetic susceptibility, environmental factors, and innate and adaptive immune responses. Despite the efficacy of current medications, many patients remain refractory, highlighting the necessity for new treatment options. Unfortunately, owing to challenges related in part to trial design and disease heterogeneity, only one new biologic in the last 50 years has been approved by the US Food and Drug Administration for the treatment of SLE. Thus, although SLE and CLE have a similar pathogenesis, patients with CLE who do not meet criteria for SLE cannot benefit from this advancement. This article discusses the recent trials and emphasizes the need to include patients with single-organ lupus, such as CLE, in SLE trials.

Cutaneous lupus erythematosus and systemic lupus erythematosus are associated with clinically significant cardiovascular risk: a Danish nationwide cohort study

Lupus ◽  
2016 ◽  
Vol 26 (1) ◽  
pp. 48-53 ◽  
Author(s):  
J Halskou Hesselvig ◽  
O Ahlehoff ◽  
L Dreyer ◽  
G Gislason ◽  
K Kofoed
Keyword(s):  
Systemic Lupus Erythematosus ◽  
Cohort Study ◽  
Cardiovascular Risk ◽  
Lupus Erythematosus ◽  
Cutaneous Lupus Erythematosus ◽  
Low Grade ◽  
Systemic Lupus ◽  
Increased Risk ◽  
All Cause Mortality ◽  
Cutaneous Lupus

Systemic lupus erythematosus (SLE) is a well-known cardiovascular risk factor. Less is known about cutaneous lupus erythematosus (CLE) and the risk of developing cardiovascular disease (CVD). Therefore, we investigated the risk of mortality and adverse cardiovascular events in patients diagnosed with SLE and CLE. We conducted a cohort study of the entire Danish population aged ≥ 18 and ≤ 100 years, followed from 1997 to 2011 by individual-level linkage of nationwide registries. Multivariable adjusted Cox regression models were used to estimate the hazard ratios (HRs) for a composite cardiovascular endpoint and all-cause mortality, for patients with SLE and CLE. A total of 3282 patients with CLE and 3747 patients with SLE were identified and compared with 5,513,739 controls. The overall HR for the composite CVD endpoint was 1.31 (95% CI 1.16–1.49) for CLE and 2.05 (95% CI 1.15–3.44) for SLE. The corresponding HRs for all-cause mortality were 1.32 (95% CI 1.20–1.45) for CLE and 2.21 (95% CI 2.03–2.41) for SLE. CLE and SLE were associated with a significantly increased risk of CVD and all-cause mortality. Local and chronic inflammation may be the driver of low-grade systemic inflammation.

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