Dermoscopy in the differential diagnosis between malar rash of systemic lupus erythematosus and erythematotelangiectatic rosacea: an observational study

Lupus ◽  
2019 ◽  
Vol 28 (13) ◽  
pp. 1583-1588
Author(s):  
E Errichetti ◽  
A Lallas ◽  
G De Marchi ◽  
Z Apalla ◽  
A Zabotti ◽  
...  
Keyword(s):  
Systemic Lupus Erythematosus ◽  
Differential Diagnosis ◽  
Comparative Analysis ◽  
Observational Study ◽  
Diagnostic Criteria ◽  
Lupus Erythematosus ◽  
Systemic Lupus ◽  
Predictive Values ◽  
Malar Rash ◽  
Dermoscopic Image

Background Malar rash is one of the three cutaneous diagnostic criteria of systemic lupus erythematosus (SLE). Although its clinical recognition is often straightforward, the differential diagnosis with erythematotelangiectatic rosacea may sometimes be challenging. Objective To describe dermoscopic features of SLE malar rash and investigate the accuracy of dermoscopy for the differential diagnosis with erythematotelangiectatic rosacea. Methods A representative dermoscopic image of target areas was evaluated for the presence of specific features. Fisher’s test was used to compare their prevalence between the two cohorts, and accuracy parameters (specificity, sensitivity, and positive and negative predictive values) were evaluated. Results Twenty-eight patients were included in the analysis, of which 13 had SLE malar rash and 15 erythematotelangiectatic rosacea. The main dermoscopic features of malar rash were reddish/salmon-coloured follicular dots surrounded by white halos (‘inverse strawberry’ pattern), being present in 53.9% of the cases, while network-like vessels (vascular polygons) turned out to be the main feature of erythematotelangiectatic rosacea, with a prevalence of 93.3%. The comparative analysis showed that the ‘inverse strawberry’ pattern was significantly more common in SLE malar rash, with a specificity of 86.7%, while vascular polygons were significantly more frequent in rosacea, with a specificity of 92.3%. Conclusion Dermoscopy may be a useful support to distinguish SLE malar rash and erythematotelangiectatic rosacea by showing peculiar features.

scholarly journals Differential diagnosis of a thyroid mass, facial malar rash and ptosis on the flora in the primavera by Sandro Botticelli (1445–1510)

2021 ◽  
Author(s):  
H. Ashrafian
Keyword(s):  
Systemic Lupus Erythematosus ◽  
Lupus Erythematosus ◽  
Systemic Lupus ◽  
Bilateral Ptosis ◽  
Malar Rash ◽  
Autoimmune Syndrome ◽  
Thyroid Mass ◽  
Multiple Autoimmune Syndrome ◽  
Sandro Botticelli ◽  
Renaissance Artist

Abstract Purpose The Primavera is considered amongst the greatest and controversial artistic masterpieces worldwide painted by renaissance artist Sandro Botticelli. The aim was to identify any underlying medical foundations for the painting. Methods Observational study. Results The painting reveals, a ‘butterfly’ malar rash, bilateral ptosis and a clear neck swelling consistent with a goitre in the figure of Flora. This could be explained by concomitant Graves’ disease and systemic lupus erythematosus, or other presentations of multiple autoimmune syndrome. Conclusion These findings highlight the likely presentation of the earliest pictorial depictions of thyroid disease with systemic lupus erythematosus and emphasize the exactitude of depiction demonstrated by Botticelli in renaissance era.

scholarly journals Autoantibodies in Neuropsychiatric Systemic Lupus Erythematosus (NPSLE): Can They Be Used as Biomarkers for the Differential Diagnosis of This Disease?

2021 ◽  
Author(s):  
Elias Manca
Keyword(s):  
Systemic Lupus Erythematosus ◽  
Central Nervous System ◽  
Nervous System ◽  
Differential Diagnosis ◽  
Human Body ◽  
Lupus Erythematosus ◽  
Neuropsychiatric Symptoms ◽  
Systemic Lupus ◽  
Neuropsychiatric Systemic Lupus Erythematosus ◽  
The Central Nervous System

AbstractSystemic lupus erythematosus is a complex immunological disease where both environmental factors and genetic predisposition lead to the dysregulation of important immune mechanisms. Eventually, the combination of these factors leads to the production of self-reactive antibodies that can target any organ or tissue of the human body. Autoantibodies can form immune complexes responsible for both the organ damage and the most severe complications. Involvement of the central nervous system defines a subcategory of the disease, generally known with the denomination of neuropsychiatric systemic lupus erythematosus. Neuropsychiatric symptoms can range from relatively mild manifestations, such as headache, to more severe complications, such as psychosis. The evaluation of the presence of the autoantibodies in the serum of these patients is the most helpful diagnostic tool for the assessment of the disease. The scientific progresses achieved in the last decades helped researchers and physicians to discover some of autoepitopes targeted by the autoantibodies, although the majority of them have not been identified yet. Additionally, the central nervous system is full of epitopes that cannot be found elsewhere in the human body, for this reason, autoantibodies that selectively target these epitopes might be used for the differential diagnosis between patients with and without the neuropsychiatric symptoms. In this review, the most relevant data is reported with regard to mechanisms implicated in the production of autoantibodies and the most important autoantibodies found among patients with systemic lupus erythematosus with and without the neuropsychiatric manifestations.

Clinical and immunological characteristics of 150 systemic lupus erythematosus patients in Jamaica: a comparative analysis

Lupus ◽  
2017 ◽  
Vol 26 (13) ◽  
pp. 1448-1456 ◽  
Author(s):  
K C Maloney ◽  
T S Ferguson ◽  
H D Stewart ◽  
A A Myers ◽  
K De Ceulaer
Keyword(s):  
Systemic Lupus Erythematosus ◽  
Lupus Nephritis ◽  
Disease Activity ◽  
Renal Biopsy ◽  
Diagnostic Criteria ◽  
Lupus Erythematosus ◽  
Antinuclear Antibodies ◽  
Damage Index ◽  
Systemic Lupus ◽  
Dsdna Antibodies

Background Epidemiological studies in systemic lupus erythematosus have been reported in the literature in many countries and ethnic groups. Although systemic lupus erythematosus in Jamaica has been described in the past, there has not been a detailed evaluation of systemic lupus erythematosus patients in urban Jamaica, a largely Afro-Caribbean population. The goal of this study was to describe the clinical features, particularly disease activity, damage index and immunological features, of 150 systemic lupus erythematosus subjects. Methods 150 adult patients (≥18 years) followed in rheumatology clinic at a tertiary rheumatology hospital centre (one of two of the major public referral centres in Jamaica) and the private rheumatology offices in urban Jamaica who fulfilled Systemic Lupus International Collaborating Clinics (SLICC) criteria were included. Data were collected by detailed clinical interview and examination and laboratory investigations. Hence demographics, SLICC criteria, immunological profile, systemic lupus erythematosus disease activity index 2000 (SLEDAI-2K) and SLICC/American College of Rheumatology (ACR) damage index (SDI) were documented. Results Of the 150 patients, 145 (96.7%) were female and five (3.3%) were male. The mean age at systemic lupus erythematosus onset was 33.2 ± 10.9. Mean disease duration was 11.3 ± 8.6 years. The most prevalent clinical SLICC criteria were musculoskeletal, with 141 (94%) of subjects experiencing arthralgia/arthritis, followed by mucocutaneous manifestations of alopecia 103 (68.7%) and malar rash 46 (30.7%), discoid rash 45 (30%) and photosensitivity 40 (26.7%). Lupus nephritis (biopsy proven) occurred in 42 (28%) subjects and 25 (16.7%) met SLICC diagnostic criteria with only positive antinuclear antibodies/dsDNA antibodies and lupus nephritis on renal biopsy. The most common laboratory SLICC criteria were positive antinuclear antibodies 136 (90.7%) followed by anti-dsDNA antibodies 95 (63.3%) and low complement (C3) levels 38 (25.3%). Twenty-seven (18%) met SLICC diagnostic criteria with only positive antinuclear antibodies/anti-dsDNA antibodies and lupus nephritis on renal biopsy. Mean SLEDAI score was 6.9 ± 5.1 with a range of 0–32. Organ damage occurred in 129 (86%) patients; mean SDI was 2.4 ± 1.8, with a range of 0–9. Conclusion These results are similar to the clinical manifestations reported in other Afro-Caribbean populations; however, distinct differences exist with respect to organ involvement and damage, particularly with respect to renal involvement, which appears to be reduced in our participants.

Splenectomy in systemic lupus erythematosus and autoimmune hematologic disease: a comparative analysis

2018 ◽  
Vol 37 (4) ◽  
pp. 943-948 ◽  
Author(s):  
Nahim Barron ◽  
Jesús Arenas-Osuna ◽  
Gabriela Medina ◽  
María Pilar Cruz-Dominguez ◽  
Fernando González-Romero ◽  
...  
Keyword(s):  
Systemic Lupus Erythematosus ◽  
Comparative Analysis ◽  
Lupus Erythematosus ◽  
Systemic Lupus ◽  
Hematologic Disease

scholarly journals PSEUDOTUMOR CEREBRI AS A DIFFERENTIAL DIAGNOSIS FOR VISION LOSS IN SYSTEMIC LUPUS ERYTHEMATOSUS: CASE REPORT

2019 ◽  
Author(s):  
MARCO FELIPE MACÊDO ALVES ◽  
CAIO FELIPE FARIAS BARROS ◽  
JARDELINA BRENA ROCHA LEITE ◽  
MARINA ACEVEDO ZARZAR DE MELO ◽  
PEDRO JOSÉ GALVÃO FREIRE ◽  
...  
Keyword(s):  
Systemic Lupus Erythematosus ◽  
Differential Diagnosis ◽  
Case Report ◽  
Lupus Erythematosus ◽  
Vision Loss ◽  
Pseudotumor Cerebri ◽  
Systemic Lupus ◽  
Systemic Lupus Erythematosus Case

scholarly journals Capillaroscopic nail fold changes in collagen vascular diseases: A prospective observational study from a tertiary care teaching hospital in Western India

2021 ◽  
Vol 7 (4) ◽  
pp. 347-352
Author(s):  
Ratnakar Shukla ◽  
Sheena Kapoor ◽  
Sharmila Patil ◽  
Anant Patil
Keyword(s):  
Systemic Lupus Erythematosus ◽  
Systemic Sclerosis ◽  
Observational Study ◽  
Lupus Erythematosus ◽  
Prospective Observational Study ◽  
Raynaud’S Phenomenon ◽  
Tertiary Care ◽  
Vascular Diseases ◽  
Systemic Lupus ◽  
Collagen Vascular Diseases

: To examine nail changes with capillaroscopy in patients with collagen vascular diseases. In this prospective observational study, patients with collagen vascular diseases presented to dermatology outpatient department of a tertiary care center were subjected to capillaroscopy. Structural and morphological abnormalities in these patients were noted. Fifty patients (Mean age 38.2 years; 86% females) with mean disease duration of 1.96 years were included. Patients with systemic sclerosis and systemic lupus erythematosus constituted 34% and 32% patients respectively. Twenty two (44%) patients had presence of dilated nail fold capillary loops. Out of 17 patients with systemic sclerosis, 15(88.23%) and 14(87.5%) showed dilated nail fold capillary loops and capillary drop-pouts respectively. Capillary dropouts were observed in 14(82.35%) patients. Raynaud’s phenomenon, splinter hemorrhage and fingertip scarring was observed in 11(64.71%), six (35.29%) and 33(17.65%) patients respectively. Ragged cuticle was observed in four (25%) patients with systemic lupus erythematosus. In our study, systemic sclerosis and systemic lupus erythematosus were two most common disorders. Dilated nail fold capillary loops/giant capillaries were the most common observation in overall population. Dilated nail fold capillary loops, capillary dropouts, Raynaud’s phenomenon, splinter hemorrhage and fingertip scarring were common in patients with systemic sclerosis.

scholarly journals Liver involvement in patients with systemic lupus erythematosus

2021 ◽  
Vol 59 (2) ◽  
pp. 164-172
Author(s):  
A. P. Panova ◽  
V. G. Avdeev ◽  
T. N. Krasnova ◽  
T. P. Rozina ◽  
E. P. Pavlikova ◽  
...  
Keyword(s):  
Systemic Lupus Erythematosus ◽  
Differential Diagnosis ◽  
Lupus Erythematosus ◽  
Liver Diseases ◽  
Liver Enzymes ◽  
Liver Steatosis ◽  
Liver Involvement ◽  
Systemic Lupus ◽  
Viral Hepatitis C ◽  
Lupus Hepatitis

Liver involvement in systemic lupus erythematosus is common and in most cases clinical course is asymptomatic, that makes diagnosis difficult. Determination of the cause of the liver involvement is important to select treatment and to evaluate the prognosis of the disease.The aim of the research was to characterize the clinical features of liver involvement in patients with systemic lupus erythematosus and identify the most significant clinical and laboratory parameters for the differential diagnosis of lupus hepatitis.Materials and methods. The study included 313 patients with systemic lupus erythematosus observed in the E.M. Tareev Clinic of Rheumatology, Internal Medicine and Occupational Diseases of I.M. Sechenov First Moscow State Medical University (Sechenov University) in the period from 2001 to 2019. The verification of diagnosis of systemic lupus erythematosus was based on the criteria of the American College of Rheumatology (1997). Patients examination included complete blood count, biochemical and immunological blood tests and an abdominal ultrasonography. In 13 cases hepatic autoantibodies (ASMA, anti-LKM-1, LC-1, SLA-LP, AMA-M2) were analyzed, in 4 – magnetic resonance cholangiopancreatography and in 6 – liver biopsy were made.Results. Liver involvement were represented by an increase of liver enzymes in 58 (18.5%) cases. Chronic viral hepatitis C was diagnosed in 4 (1.3%) patients. Drug-induced hepatitis was found in 17 (5.4%) patients. Autoimmune liver diseases occured in 2 (0.6%) patients. In 2 (0.6%) patients, liver damage was associated with thrombotic microangiopathy (atypical hemolytic uremic syndrome, hereditary thrombophilia). In 15 (4.8%) cases, the most likely diagnosis was NAFLD. Lupus hepatitis was the most likely cause in 18 (5.7%) patients. Differential diagnosis in cases of liver involvement in patients with systemic lupus erythematosus requires assessment of risk factors for various liver diseases, age of the patients, level of liver enzymes, lupus activity, ultrasound signs of liver steatosis and secondary antiphospholipid syndrome.Determining the cause of the liver involvement for the patients with the systemic lupus erythematosus allows establishing better treatment tactic and improvement of the prognosis.

Sign in / Sign up

Export Citation Format

Share Document