Clinical Aspects of Lupus Erythematosus

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Questions and Answers

What histological feature is suggested by direct immunofluorescence in cases where differential diagnosis is difficult?

Lymphoid infiltration

Mucin deposits in the dermis

Discrete infiltrations

Hydropic degeneration of the basal epidermis (correct)

What is the expression of chemokines, specifically regulated by interferons, in relation to CLE?

Decreased expression of MxA and CXCL10

Strong expression of MxA and CXCL10 (correct)

Moderate expression of chemokines

Absence of chemokines

In which scenario is direct immunofluorescence of non-lesional skin not recommended?

When the skin has been exposed to light (correct)

In cases of suspected interface dermatitis

When lymphoid infiltration is present

When analyzing lesions not exposed to light

What type of cell predominates in the lymphoid infiltration associated with CLE?

T cells Signup and view all the answers

Which abnormality is associated with the histology of acute cutaneous lupus erythematosus (ACLE)?

Interface dermatitis Signup and view all the answers

Which of the following institutions is associated with pediatric rheumatology?

Charité – Universitätsmedizin Berlin Signup and view all the answers

What is the role of the Hamburg Center for Pediatric and Adolescent Rheumatology?

It provides care for pediatric and adolescent rheumatology patients Signup and view all the answers

Which of the following departments is NOT mentioned as related to rheumatology?

Department of Orthopedics, Vivantes Klinikum Neukölln Signup and view all the answers

Which city hosts the department of Dermatology and Venereology associated with the Vivantes Klinikum Neukölln?

Berlin Signup and view all the answers

What type of specialties does the Clinic and Functional Division for Rheumatology at University Hospital Düsseldorf cover?

Rheumatology-focused medical care Signup and view all the answers

What is the primary focus of the studies mentioned in the content?

Clinical and laboratory studies related to lupus erythematosus Signup and view all the answers

Which study design was utilized in examining the photoprotective effects of broad-spectrum sunscreen?

Randomized, vehicle-controlled, double-blind study Signup and view all the answers

Which organization published updated classification criteria for systemic lupus erythematosus?

European League Against Rheumatism Signup and view all the answers

What outcome instrument was developed for assessing cutaneous lupus erythematosus?

Cutaneous Lupus Erythematosus Disease Area and Severity Index (CLASI) Signup and view all the answers

What is a rare potential complication associated with healed scars of cutaneous lupus erythematosus?

Squamous cell carcinoma Signup and view all the answers

What treatment approach was highlighted for managing systemic lupus erythematosus?

Therapeutic drug updates Signup and view all the answers

Which condition is directly linked to ultraviolet exposure according to the content?

Lupus erythematosus Signup and view all the answers

What percentage of cases does discoid lupus erythematosus (DLE) present as the first sign of systemic lupus erythematosus (SLE)?

10% Signup and view all the answers

Which clinical appearance characterizes lupus erythematosus tumidus (LET)?

Annular or semicircular erythematous plaques Signup and view all the answers

What was one of the methods used to assess disease activity in systemic lupus erythematosus?

Lupus band test Signup and view all the answers

What is a potential benefit of using sunscreen in patients with cutaneous lupus erythematosus?

It can prevent interferon-driven skin inflammation Signup and view all the answers

Which of the following describes the typical healing outcome of lupus erythematosus tumidus (LET) lesions?

Healing without scars or pigment disorders Signup and view all the answers

What is a characteristic location for lesions of lupus erythematosus profundus (LEP)?

Gluteal or hip area Signup and view all the answers

What percentage of patients with lupus erythematosus tumidus (LET) display positive results in a photo-provocation test?

Greater than 70% Signup and view all the answers

What kind of antibodies are typically absent in lupus erythematosus tumidus (LET)?

Anti-ds-DNA antibodies Signup and view all the answers

Which of the following is a notable characteristic of the lesions found in lupus erythematosus profundus (LEP)?

Firm infiltrations with adherence to skin Signup and view all the answers

What can the presence of anti-ds-DNA antibodies indicate in cutaneous lupus erythematosus?

A potential transition to systemic lupus erythematosus (SLE) Signup and view all the answers

Which of the following is NOT frequently associated with lupus erythematosus tumidus (LET)?

Lesions involving the epidermis Signup and view all the answers

Which index is used as a responsive instrument to measure activity and damage in patients with cutaneous lupus erythematosus?

Cutaneous Lupus Erythematosus Disease Area and Severity Index Signup and view all the answers

What does the revised Cutaneous Lupus Erythematosus Disease Area and Severity Index (RCLASI) modify?

Outcome instrument for cutaneous lupus erythematosus Signup and view all the answers

What condition is associated with incidental cases of subacute cutaneous lupus erythematosus?

Malignancy Signup and view all the answers

Which haplotype is considered an independent risk factor for cutaneous lupus erythematosus?

HLA DRB1*0301 Signup and view all the answers

What year was the update of the EULAR recommendations for managing systemic lupus erythematosus published?

2019 Signup and view all the answers

Which of the following studies expanded the Cutaneous Lupus Erythematosus Disease Activity and Severity Index for rheumatology and dermatology?

Krathen et al. 2008 Signup and view all the answers

Which evaluation method assesses disease activity and damage in different subtypes of cutaneous lupus erythematosus?

CLASI Signup and view all the answers

Which year was the study on polymorphic light eruption and its independent risk factors for cutaneous lupus erythematosus published?

2001 Signup and view all the answers

Study Notes

Institutions Involved

Charité – Universitätsmedizin Berlin is a leading medical institution in Germany.
Collaborating institutions include Free University of Berlin, Humboldt University of Berlin, and Berlin Institute of Health.
Other significant affiliations include Vivantes Klinikum Neukölln, University Hospital Düsseldorf, Hamburg Center for Pediatric and Adolescent Rheumatology, and Technical University of Dresden.

Cutaneous Lupus Erythematosus (CLE)

Rarely, squamous cell carcinoma may arise from healed scars associated with CLE.
Discoid lupus erythematosus (DLE) appears in 10% of cases as the initial sign of systemic lupus erythematosus (SLE).

Clinical Features of Lupus Erythematosus Tumidus (LET)

Characterized by succulent, indurated, urticarial-like erythematous plaques, smooth-surfaced and not involving the epidermis.
Commonly observed in sun-exposed areas such as the face, upper trunk, and arms.
Healing typically occurs without scarring or pigment alterations.

Lupus Erythematosus Profundus (LEP)

Presents as subcutaneous nodular or discoid lesions that are firm and can adhere to the skin.
Predilection sites include gluteal areas and thighs, often presenting with erythema and potential for ulceration or calcification.
Up to 75% of cases show positive antinuclear antibodies (ANA), with spontaneous remission occurring frequently.

Diagnostic Insights

Direct immunofluorescence (DIF) shows interface dermatitis and hydropic degeneration of the basal epidermis; indicated especially in difficult differential diagnoses.
Strong expression of chemokines regulated by interferons is observed in CLE.

Photosensitivity and Antibodies

High photosensitivity recorded in over 70% of patients through positive provocation tests with UVA/UVB.
Anti-Ro/SSA and anti-La/SSB antibodies found in approximately 5% of cases.

Histological Findings

Direct immunofluorescence testing of non-affected skin exposed to sunlight is not recommended.
Lymphoid infiltrate includes plasmacytoid dendritic cells and T cells, with significant dermal mucin deposits noted.

Miscellaneous

Evaluation and management recommendations follow 2019 EULAR guidelines on systemic lupus erythematosus.
Research includes classifications and severity indices relevant for dermatology and rheumatology practices.

These study notes compile essential facts regarding cutaneous lupus erythematosus pathology, presentations, and associated diagnostic and histological features.

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Description

Explore the clinical features and institutions involved in the study of Cutaneous Lupus Erythematosus (CLE) and Lupus Erythematosus Tumidus (LET). This quiz highlights the associations between lupus and other medical conditions, as well as key research institutions in Germany. Test your knowledge about the significance and manifestations of these rare skin conditions.