scholarly journals Review Article: Systemic Lupus Erythematosus

2020 ◽  
Vol 5 (1) ◽  
pp. 1-4
Author(s):  
Habib N
Keyword(s):  
Systemic Lupus Erythematosus ◽  
Lupus Erythematosus ◽  
Immune Complexes ◽  
Cutaneous Lupus Erythematosus ◽  
The Body ◽  
Discoid Lupus Erythematosus ◽  
Systemic Lupus ◽  
Internal Organs ◽  
Body Tissues ◽  
Antibody Reaction

Systemic lupus erythematosus or SLE is a persistent heterogeneous autoimmune disease that affects multisystem of the body. It is distinguished by acute and chronic inflammation of various tissues and even organs of the body principally the skin and joints. Systemic lupus erythematosus is a multisystem disorder and hence, it can affect any tissues, organs and even systems of the body. There are few categories of lupus for instance, lupus dermatitis or cutaneous lupus erythematosus (CLE) that affects the skin and causes malar rash, discoid lupus erythematosus (DLE) as well as systemic lupus erythematosus that causes damage to single or multiple internal organs. The damage is due to the inflammation that is caused by direct antibody reaction to the body tissues as well the deposition of immune complexes. Glucocorticoids, immunosuppressant, and anti- malarial are the combination therapy used to treat SLE besides providing counseling and awareness. Lupus erythematosus in any form particularly systemic lupus erythematosus (SLE) are prevalent in women compared to men with ratio of 6:1. It has the tendency to affect all ages but most frequently attacks women of aged 20 to 45 years old compared to men. On the other hand, if lupus erythematosus causes damage to internal organs either single or multiple, it is known as systemic lupus erythematosus. The damage is due to the inflammation that is caused by direct antibody reaction to the body tissues as well the deposition of immune complexes.

scholarly journals Monitoring of serum TWEAK levels guides glucocorticoid dosages in the treatment of systemic lupus erythematosus

2019 ◽  
Author(s):  
Jingyun Chen ◽  
Huixia Wang ◽  
Yi Wu ◽  
Xiaokang Wu ◽  
Li Wang ◽  
...  
Keyword(s):  
Systemic Lupus Erythematosus ◽  
Disease Activity ◽  
Lupus Erythematosus ◽  
Activity Index ◽  
White Blood Cells ◽  
Cutaneous Lupus Erythematosus ◽  
Glucocorticoid Therapy ◽  
Discoid Lupus Erythematosus ◽  
Systemic Lupus ◽  
Serum Samples

Abstract Background Accurate assessment of systemic lupus erythematosus (SLE) disease activity is critical. Currently existing indices or measures for assessment are either expensive, intricate, or inaccurate. The novel indices with higher sensitivity and specificity have become one of the aims of the investigators. This study was designed to explore the relationship between serum tumor necrosis factor-like weak inducer of apoptosis (TWEAK) and systemic lupus erythematosus disease activity index (SLEDAI) as well as its role in guiding glucocorticoid dosages in the treatment of SLE. Of 59 patients with SLE, 20 patients with subacute cutaneous lupus erythematosus (SCLE), 13 patients with discoid lupus erythematosus (DLE) and 32 healthy volunteers, soluble TWEAK level was determined in both serum and urine. Monomeric C-reactive protein, antinuclear antibody, interleukin 6, complements, erythrocyte sedimentation rate, and white blood cells were measured in serum samples. Moreover, SLEDAI-2K was used for evaluating the disease. Finally, methylprednisolone was administrated orally to SLE patients with the doses depending on serum TWEAK levels. Results We found that serum TWEAK levels are higher in patients with SLE (383.0 ± 45.37 ng/ml, p < 0.001 for both) or SCLE (129.1 ± 25.73 ng/ml, p < 0.05 for both) than in patients with DLE (78.38 ± 22.85 ng/ml) or in healthy controls (78.38 ± 22.85 ng/ml). Also, serum TWEAK levels correlate positively with SLEDAI-2K in patients with SLE (r2 = 0.101, p < 0.001), whereas urine TWEAK levels reflect renal damage in patients with lupus nephritis. Moreover, serum TWEAK levels had a higher correlation coefficient with SLEDAI-2K scores compared with the other serum parameters. Furthermore, TWEAK-based glucocorticoid therapy is associated with lower SLEDAI-2K scores and fewer flares in patients with SLE. Conclusions Serum TWEAK is a useful biomarker reflecting SLE disease, and monitoring of serum TWEAK levels can improve the outcomes of glucocorticoid therapy for patients with SLE.

Spectrum of cutaneous lupus erythematosus in South Africans with systemic lupus erythematosus

Lupus ◽  
2019 ◽  
Vol 28 (8) ◽  
pp. 1021-1026 ◽  
Author(s):  
K Koch ◽  
M Tikly
Keyword(s):  
Systemic Lupus Erythematosus ◽  
Renal Disease ◽  
Lupus Erythematosus ◽  
Odds Ratio ◽  
Systemic Disease ◽  
Cutaneous Lupus Erythematosus ◽  
Discoid Lupus Erythematosus ◽  
Systemic Lupus ◽  
South Africans ◽  
Cutaneous Lupus

Background Cutaneous involvement is very common in systemic lupus erythematosus. We describe the prevalence and spectrum of lupus-specific (cutaneous lupus erythematosus) and non-specific cutaneous features amongst mostly black South Africans with systemic lupus erythematosus. Patients and methods A retrospective record review of 298 South Africans (262 blacks and 36 non-blacks) with systemic lupus erythematosus was carried out. Cutaneous features were classified according to the Gilliam and Sontheimer classification of cutaneous lupus. Results Most (81.5%) patients were black African females. The mean (SD) age at diagnosis and follow-up duration were 35.0 (11.8) and 8.0 (5.9) years, respectively. Cutaneous lupus erythematosus was seen in 76.1% of patients, mainly chronic cutaneous lupus erythematosus with the discoid lupus erythematosus subtype seen in 52.1% of patients. Acute cutaneous lupus erythematosus was seen in 30.2% of patients and was more common in non-blacks than blacks (odds ratio = 3.8 (1.9–7.9)); localized acute cutaneous lupus erythematosus was more common than generalized acute cutaneous lupus erythematosus (odds ratio = 2.6 (1.6–4.4)). Non-specific cutaneous features occurred in 77.2%, with oral/nasal ulcers and Raynaud’s phenomenon each occurring in approximately 40% of patients. Diffuse melanonychia at initial diagnosis was present in 37.4% of patients and was more common in blacks than non-blacks (odds ratio = 3.1 (1.3–7.3)). Acute cutaneous lupus erythematosus was associated with renal disease (odds ratio = 2.8 (1.6–4.7)) and chronic cutaneous lupus erythematosus with arthritis (odds ratio = 2.02 (1.24–3.29)). Diffuse melanonychia was associated with less renal disease and anti-dsDNA antibody positivity (odds ratio = 0.4 (0.3–0.7) and 0.4 (0.2–0.6), respectively) and significantly lower lupus severity index scores (mean (SD) = 5.99 (1.11) vs 6.56 (1.36) in patients with no melanonychia, p < 0.05)). Conclusion In this study of South Africans with systemic lupus erythematosus, the skin was the most commonly affected organ. In general, cutaneous lupus erythematosus was associated with less severe systemic disease. Acute cutaneous lupus erythematosus was less common in blacks, whereas discoid lupus erythematosus was more common than reported in Caucasians. Diffuse melanonychia was a distinctive finding and was associated with milder systemic disease.

scholarly journals Successful treatment with hydroxychloroquine for systemic lupus erythematosus with cutaneous involvement accompanied by a xanthomatous reaction

Lupus ◽  
2019 ◽  
Vol 29 (1) ◽  
pp. 79-82
Author(s):  
K Takezawa ◽  
I Ueda-Hayakawa ◽  
F Yamazaki ◽  
N Kambe ◽  
Y Son ◽  
...  
Keyword(s):  
Systemic Lupus Erythematosus ◽  
Hair Loss ◽  
Lupus Erythematosus ◽  
Cutaneous Lupus Erythematosus ◽  
Inflammatory Cells ◽  
Skin Lesions ◽  
Discoid Lupus Erythematosus ◽  
Parietal Region ◽  
Systemic Lupus ◽  
Vacuolar Degeneration

Antimalarials are usually recommended for the first-line systemic treatment of cutaneous lupus erythematosus. Alopecia in patients with discoid lupus erythematosus (DLE) is sometimes a refractory condition in spite of topical therapies. We herein described a case of DLE on the scalp with a pathological change of a xanthomatous reaction, which was successfully treated with hydroxychloroquine (HCQ). A 34-year-old woman presented with hair loss to the parietal region. She had been diagnosed with systemic lupus erythematosus (SLE) four years previously. Treatment with 30 mg/day of prednisolone (PSL) had been initiated, and the dose was gradually reduced. At 10 mg/day of PSL, she had noticed her hair loss. Physical examination revealed some small erythematous lesions to the parietal region with accompanying hair loss. Pathological findings of the erythematous lesion on her head revealed thickening of the basement membrane zone, the interface dermatitis with vacuolar degeneration, and both superficial perivascular and perifollicular infiltration of inflammatory cells in the dermis. In addition, there was an infiltrate of xanthomatous cells detected in the papillary dermis, which were positive for CD68 and CD163. The patient started treatment with HCQ at a dose of 200 mg/day. The skin lesions completely resolved within five months after initiation of HCQ without increase in the dose of PSL. Xanthomatous reactions are rarely recognized in lupus erythematosus. The chronic epithelial injury in DLE could be implicated in triggering the secondary reactive process of a xanthomatous reaction. We believe that the reaction seen in our patient was a secondary change to pathological alteration due to SLE. However, as yet unrecognized factors may play a role in the development of a xanthomatous reaction in DLE.

scholarly journals Hyaluronidase in the treatment of papular dermal mucinosis: First case reported in North America

2016 ◽  
Vol 1 (2) ◽  
Author(s):  
Arathi Ramamurthi ◽  
Lindsay Bicknell ◽  
Morgan McCarty
Keyword(s):  
Systemic Lupus Erythematosus ◽  
North America ◽  
Lupus Erythematosus ◽  
Monoclonal Gammopathy ◽  
Clinical Presentation ◽  
Discoid Lupus Erythematosus ◽  
Systemic Lupus ◽  
Internal Organs ◽  
Concurrent Disorders ◽  
First Case

<p>Papular mucinosis is an uncommon, idiopathic disorder characterized by dermal mucin deposition and increased collagen in the skin and internal organs. Its clinical presentation is characterized by dome-shaped, flesh colored papules that are closely spaced or linearly arranged. Papular mucinosis has been individually associated with several entities that include discoid lupus erythematosus, systemic lupus erythematosus and monoclonal gammopathy of undetermined significance. We encountered a 60-year-old woman with papular mucinosis in the setting of three concurrent disorders: discoid lupus erythematous, systemic lupus erythematosus and IgG paraproteinemia. Furthermore, we have reported the first case in North America of papular mucinosis being successfully treated with intralesional hyaluronidase.</p>

scholarly journals Cutaneous manifestations of systemic lupus erythematosus: experience from a tertiary care hospital of Bangladesh

2021 ◽  
Vol 12 (1) ◽  
pp. 57-61
Author(s):  
Mohammad Asifuzzaman ◽  
Rowsan Ara ◽  
Tonmoy Biswas ◽  
Rashedul Hassan ◽  
Minhaj Rahim Choudhury
Keyword(s):  
Systemic Lupus Erythematosus ◽  
Lupus Erythematosus ◽  
Renal Involvement ◽  
Cutaneous Lupus Erythematosus ◽  
Classification Criteria ◽  
The Body ◽  
Organ Involvement ◽  
Care Hospital ◽  
Systemic Lupus ◽  
Cutaneous Manifestations

Background: Systemic lupus erythematosus (SLE) is a chronic, multisystem disorder that can affect any organ of the body. Approximately 80 percent of patients develop skin disease at some point in their disease course. The association with SLE varies among the subtypes of cutaneous lupus erythematosus (LE). Better understanding of cutaneous manifestations can help in more effective management. This study aimed to evaluate the pattern of cutaneous manifestations of SLE and to find out association with organ involvement. Methods: This cross-sectional observational study was conducted in the Green Life Medical College Hospital from January 2019 to December 2020. Sixty four lupus patients who fulfilled the SLICC 2012 classification criteria and having new onset or preexisting skin complaints were enrolled. Mixed connective tissue disease and other overlap syndromes were excluded. All patients were evaluated by a dermatologist and diagnosis was done as per modified Gilliam Classification criteria. Results: Out of 64 patients, 56 were female and 8 were male. Female and male ratio was 7:1. Mean age was 28.4±9.6 years. Among the cutaneous manifestations, LE specific was 38 (59.4%), LE non-specific was 41 (64.1%). Among LE specific, 66% were acute (ACLE), 42% were sub-acute (SCLE) and 37% patients were chronic (CCLE). Among ACLE, 72% had malar rash and 84% had photosensitivity. Among SCLE, most common was papulosqumous (68%). DLE (86%) was the most common CCLE. Among LE non-specific, 85% had non-scarring alopecia, 52% had vascular abnormalities. Most common organ involvement was musculoskeletal (84%), then renal (56%). DLE had negative association with renal involvement [OR (-0.04)]. No other cutaneous manifestations showed any significant association with any other organ involvement. Conclusion: Cutaneous manifestations are important feature in SLE. LE non-specific was more common than LE specific manifestations in this study. Better understanding can help in efficient diagnosis and management. BIRDEM Med J 2022; 12(1): 57-61

Coagulation and Fibrinolysis Study in Systemic Lupus erythematosus: Haematological, Urinary and Tissue Parameters

1981 ◽  
Vol 46 (03) ◽  
pp. 575-580 ◽  
Author(s):  
P Stratta ◽  
C Canavese ◽  
P Valmaggia ◽  
M Rotunno ◽  
E Levi ◽  
...  
Keyword(s):  
Systemic Lupus Erythematosus ◽  
Lupus Erythematosus ◽  
Immune Complexes ◽  
Acute Stage ◽  
Systemic Lupus ◽  
Immunological Activity ◽  
Coagulation Abnormalities ◽  
Coagulation And Fibrinolysis

SummaryHaematochemical, urinary and tissue parameters were examined in the elaboration of the coagulation and fibrinolysis profile in 33 cases of systemic lupus erythematosus in different stages of the disease. Coagulation abnormalities varied from hypo- to hyper-coagulabitity, these being often associated in the same patient, either simultaneously or at different stages of the disease. Activation of coagulation, closely related to the immunological activity of the disease, was present in 80% cases in the acute stage, and 36% of those in the remission stage. The lupus-like anticoagulant was not much involved, and platelets were the prime figures in the haemostatic abnormalities of lupus, those being the preferred target of direct antibody activities, or possibly of immune complexes as well. Activation of the coagulatory cascade is not uncommonly accompanied by a thrombophilic tendency coupled with signs of consumption, this being the expression of a continuously stimulated haemostatic balance.

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