Podcast
Questions and Answers
What is one method recommended for evaluating quality of life in patients with cutaneous lupus erythematosus (CLE)?
What is one method recommended for evaluating quality of life in patients with cutaneous lupus erythematosus (CLE)?
- ECLAM
- SELENA-SLEDAI
- DLQI or Skindex-29 (correct)
- ECLAM and BILAG
Which activity score is focused on systemic lupus erythematosus but is not ideal for assessing cutaneous symptoms?
Which activity score is focused on systemic lupus erythematosus but is not ideal for assessing cutaneous symptoms?
- ECLAM
- CLASI/RCLASI
- BILAG (correct)
- Skindex-29
Which of the following statements is true regarding the reimbursement of pacrine?
Which of the following statements is true regarding the reimbursement of pacrine?
- It is frequently not reimbursed. (correct)
- It is fully covered by health insurance.
- It is only used for cosmetic treatments.
- It is always mentioned as a first-line treatment.
What factor should be considered during treatment monitoring related to quality of life?
What factor should be considered during treatment monitoring related to quality of life?
Which score is specifically indicated for assessing disease activity in SLE?
Which score is specifically indicated for assessing disease activity in SLE?
What is the primary purpose of the DLQI and Skindex-29?
What is the primary purpose of the DLQI and Skindex-29?
Why might traditional activity scores not be suitable for assessing cutaneous lupus erythematosus (CLE)?
Why might traditional activity scores not be suitable for assessing cutaneous lupus erythematosus (CLE)?
What is a common limitation of the pacrine treatment mentioned?
What is a common limitation of the pacrine treatment mentioned?
What is the classic screening test for connective tissue diseases?
What is the classic screening test for connective tissue diseases?
Which antibodies are typical for subacute cutaneous lupus erythematosus (SCLE)?
Which antibodies are typical for subacute cutaneous lupus erythematosus (SCLE)?
What do low levels of complement C3 and C4 indicate in the context of lupus?
What do low levels of complement C3 and C4 indicate in the context of lupus?
Which antibodies are frequently found in drug-induced lupus erythematosus?
Which antibodies are frequently found in drug-induced lupus erythematosus?
What is the role of antinuclear antibodies (ANA) in the diagnosis of systemic lupus erythematosus (SLE)?
What is the role of antinuclear antibodies (ANA) in the diagnosis of systemic lupus erythematosus (SLE)?
What indicates that antiphospholipid antibodies are more indicative of SLE rather than CLE?
What indicates that antiphospholipid antibodies are more indicative of SLE rather than CLE?
What is the frequency range for antiphospholipid antibodies found in various CLE subtypes?
What is the frequency range for antiphospholipid antibodies found in various CLE subtypes?
Which of the following antibodies is NOT typical for cutaneous lupus erythematosus (CLE)?
Which of the following antibodies is NOT typical for cutaneous lupus erythematosus (CLE)?
What characterizes interface dermatitis as seen in chilblain lupus erythematosus (CHLE)?
What characterizes interface dermatitis as seen in chilblain lupus erythematosus (CHLE)?
Which of the following locations is NOT a common predilection site for chilblain lupus erythematosus?
Which of the following locations is NOT a common predilection site for chilblain lupus erythematosus?
What triggers the inflammatory response in chilblain lupus erythematosus?
What triggers the inflammatory response in chilblain lupus erythematosus?
Which immune responses are involved in chilblain lupus erythematosus?
Which immune responses are involved in chilblain lupus erythematosus?
What is a significant pro-inflammatory factor associated with chilblain lupus erythematosus?
What is a significant pro-inflammatory factor associated with chilblain lupus erythematosus?
Which symptom is characteristically associated with chilblain lupus erythematosus?
Which symptom is characteristically associated with chilblain lupus erythematosus?
The clinical and histological differentiation from genuine chilblains is considered to be:
The clinical and histological differentiation from genuine chilblains is considered to be:
What type of immune cells are primarily involved in the basal layer during chilblain lupus erythematosus?
What type of immune cells are primarily involved in the basal layer during chilblain lupus erythematosus?
What is the primary focus of the classification by Kuhn and Ruzicka in 2004?
What is the primary focus of the classification by Kuhn and Ruzicka in 2004?
Which publication discussed the epidemiology and socioeconomic impact of skin disease in lupus erythematosus?
Which publication discussed the epidemiology and socioeconomic impact of skin disease in lupus erythematosus?
What specific subgroup of cutaneous lupus erythematosus does Kuhn, Ruzicka, and others report as neglected?
What specific subgroup of cutaneous lupus erythematosus does Kuhn, Ruzicka, and others report as neglected?
Which autoantigen's expression is upregulated in patients with dermatomyositis according to Scholtissek and colleagues?
Which autoantigen's expression is upregulated in patients with dermatomyositis according to Scholtissek and colleagues?
What is a primary research focus of the work published by Jimenez et al. in relation to lupus erythematosus?
What is a primary research focus of the work published by Jimenez et al. in relation to lupus erythematosus?
In which year was the study by Kuhn and Landmann regarding the classification and diagnosis of cutaneous lupus erythematosus published?
In which year was the study by Kuhn and Landmann regarding the classification and diagnosis of cutaneous lupus erythematosus published?
What type of manifestations are primarily discussed in the work of Sontheimer and Provost related to lupus erythematosus?
What type of manifestations are primarily discussed in the work of Sontheimer and Provost related to lupus erythematosus?
What characterizes scarring skin lesions of discoid lupus erythematosus?
What characterizes scarring skin lesions of discoid lupus erythematosus?
Which journal published the study on the expression of TRIM33/TIF1gamma and its association with cellular stress markers?
Which journal published the study on the expression of TRIM33/TIF1gamma and its association with cellular stress markers?
Which type of cells are emphasized in the presence and distribution in various inflammatory skin diseases?
Which type of cells are emphasized in the presence and distribution in various inflammatory skin diseases?
What is the implication of ultraviolet A exposure for photosensitive patients?
What is the implication of ultraviolet A exposure for photosensitive patients?
Which study discusses the composition of the lupus band test on sun-protected non-lesional skin?
Which study discusses the composition of the lupus band test on sun-protected non-lesional skin?
What type of sun protection strategies are discussed for patients with lupus erythematosus?
What type of sun protection strategies are discussed for patients with lupus erythematosus?
What is not typically associated with the diagnosis and treatment of photosensitivity in lupus patients?
What is not typically associated with the diagnosis and treatment of photosensitivity in lupus patients?
Which of the following studies evaluated the capacity of sunscreens to photoprotect lupus erythematosus patients?
Which of the following studies evaluated the capacity of sunscreens to photoprotect lupus erythematosus patients?
What factor is related to the effectiveness of sun protection in lupus erythematosus patients, according to the studies?
What factor is related to the effectiveness of sun protection in lupus erythematosus patients, according to the studies?
Flashcards
Cutaneous Lupus Erythematosus (CLE)
Cutaneous Lupus Erythematosus (CLE)
A type of lupus that primarily affects the skin.
Interface dermatitis
Interface dermatitis
A skin reaction in lupus, due to anti-epidermal inflammation.
Chilblain Lupus Erythematosus (CHLE)
Chilblain Lupus Erythematosus (CHLE)
Lupus causing painful swellings in cold areas.
Symmetrical acral areas
Symmetrical acral areas
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Immune response mechanisms
Immune response mechanisms
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Autoantibodies
Autoantibodies
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T cells
T cells
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Innate immune response
Innate immune response
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Pro-inflammatory factors
Pro-inflammatory factors
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Interferons (type I/III)
Interferons (type I/III)
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Cytokines (CXCL10)
Cytokines (CXCL10)
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Antinuclear antibody (ANA)
Antinuclear antibody (ANA)
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SLE diagnosis
SLE diagnosis
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ENA tests
ENA tests
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Anti-Ro/SS-A antibodies
Anti-Ro/SS-A antibodies
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Anti-histone antibodies
Anti-histone antibodies
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Anti-ds-DNA antibodies
Anti-ds-DNA antibodies
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Anti-Sm antibodies
Anti-Sm antibodies
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Antiphospholipid Syndrome (APS)
Antiphospholipid Syndrome (APS)
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Antiphospholipid antibodies (APS-AB)
Antiphospholipid antibodies (APS-AB)
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Quality of life assessments
Quality of life assessments
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DLQI (Dermatology Life Quality Index)
DLQI (Dermatology Life Quality Index)
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Complement levels (C3 & C4)
Complement levels (C3 & C4)
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Low complement levels
Low complement levels
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Study Notes
Cutaneous Lupus Erythematosus (CLE)
- ACR criteria from 1982 are fulfilled in 35–50% of cases.
- Interface dermatitis is a histological manifestation linked to anti-epidermal inflammation in lupus.
Chilblain Lupus Erythematosus (CHLE)
- Characterized by painful, livid swellings and large, cushion-like nodes that may erode or ulcerate.
- Predominantly found in symmetrical acral areas exposed to cold (e.g., fingers, toes, ears).
- Symptoms often worsen in cold and damp conditions, particularly during winter.
Immune Response Mechanisms
- Involves both adaptive (autoantibodies, T cells) and innate immune responses (cell death, cytokine pathways).
- Key pro-inflammatory factors include type I/III interferons and cytokines like CXCL10, produced by plasmacytoid dendritic cells and keratinocytes.
Diagnosis
- Antinuclear antibody (ANA) tests are essential for diagnosing connective tissue diseases, particularly SLE, with low titers (≤ 1:320) often seen in CLE.
- Positive ANA is required for SLE diagnosis; further testing for ENA is recommended to specify subtypes.
Antibodies Associated with CLE
- Anti-Ro/SS-A antibodies are common in subacute cutaneous lupus erythematosus (SCLE).
- Anti-histone antibodies are frequently present in drug-induced lupus erythematosus, while anti-ds-DNA and anti-Sm antibodies align with SLE.
Antiphospholipid Syndrome (APS)
- Antiphospholipid antibodies (APS-AB) such as cardiolipin and lupus anticoagulant are part of the SLE diagnostic criteria and vary in frequency among CLE types (5.8–68%).
- Low complement levels (C3 and/or C4) are typical in SLE, used to monitor disease progression, unlike normal levels in CLE.
Quality of Life Assessments
- Quality of life in CLE patients can be evaluated using dermatological indices like DLQI (Dermatology Life Quality Index) and Skindex-29, especially relevant due to scarring effects.
- Activity scores like ECLAM, BILAG, SELENA-SLEDAI, and SLAM assess SLE but lack specificity for cutaneous manifestations.
Treatment Considerations
- Treatments may be influenced by cosmetic concerns related to scarring in facial and scalp lesions.
- The use of general dermatological quality of life scores is recommended for tracking treatment efficacy and patient satisfaction.
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Description
This quiz covers the histological and clinical aspects of Chilblain lupus erythematosus (CHLE) and its association with systemic lupus erythematosus (SLE). Test your knowledge on the ACR criteria from 1982 and the characteristics of interface dermatitis. Understand the clinical appearance and underlying mechanisms of this condition.
