Cutaneous Lupus Erythematosus Review 2023

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Questions and Answers

What is the relative risk of the Māori population for the development of all CLE subtypes?

3.14

4.50

5.96

2.47 (correct)

In which age range is exclusive CLE most commonly found?

20 to 40 years (correct)

30 to 50 years

10 to 20 years

40 to 60 years

Which parameter is assigned the highest score in the classification of DLE skin lesions?

Atrophic scar (correct)

Location in the pinna

Dyschromia

Erythematous to violaceous color

What method was used by the task force to propose uniformity in the classification of CLE?

The Delphi method Signup and view all the answers

What is the primary cause of morbidity associated with LE skin lesions?

Chronic nature and disfiguring sequelae Signup and view all the answers

What is the primary classification of cutaneous lupus erythematosus?

Acute, subacute, intermittent, chronic, and bullous Signup and view all the answers

Which factor is NOT associated with the pathogenesis of skin lesions in lupus erythematosus?

Viral factors Signup and view all the answers

Cutaneous lupus erythematosus can present as which of the following?

Both exclusively cutaneous and as part of systemic lupus erythematosus Signup and view all the answers

What has recent progress in understanding cutaneous lupus erythematosus targeted?

More effective treatments Signup and view all the answers

Which type of cutaneous lupus is primarily identified through clinical features and histopathological findings?

All subtypes including acute and chronic Signup and view all the answers

Which of the following is a non-specific cutaneous manifestation associated with systemic lupus erythematosus?

Photosensitivity Signup and view all the answers

Which aspect is crucial for the diagnosis of cutaneous lupus erythematosus?

Histopathological examination and clinical features Signup and view all the answers

Systemic lupus erythematosus may exhibit which of the following symptoms?

Joint pain and systemic symptoms Signup and view all the answers

What percentage sensitivity is ensured with a score of 5 or greater for classification as DLE?

84% Signup and view all the answers

Which classification system provided the highest overall diagnostic accuracy for SLE?

SLICC 2012 Signup and view all the answers

What factor is NOT mentioned as contributing to the multifactorial nature of SLE and CLE?

Chronic stress Signup and view all the answers

Which classification system was proposed in 1981 and focused on differentiating cutaneous lesions?

Gilliam & Sontheimer Signup and view all the answers

Which classification criteria showed the highest specificity for SLE classification?

ACR 1997 Signup and view all the answers

What classifies eczematous lesions according to the classification proposed by Gilliam & Sontheimer?

Both specific and nonspecific lesions Signup and view all the answers

Which environmental exposure is mentioned as a factor for triggering SLE and CLE?

Ultraviolet radiation Signup and view all the answers

What aspect of genetic research in CLE is described as still incipient compared to SLE?

Overall understanding of genetic factors Signup and view all the answers

What is the significance of identifying the subtypes of cutaneous lupus erythematosus (CLE)?

It helps in determining the treatment options available. Signup and view all the answers

Which condition is NOT associated with interface dermatitis?

Acute cutaneous lupus erythematosus Signup and view all the answers

How does the prevalence of systemic lupus erythematosus (SLE) in females compare to that of isolated cutaneous lupus erythematosus (CLE)?

Females are more affected in both conditions, but the ratio is different. Signup and view all the answers

What is the annual incidence rate of exclusive CLE in Europe and the US?

4.3/100,000 Signup and view all the answers

Which racial group has the highest risk of chronic cutaneous lupus erythematosus (CCLE)?

African-Americans Signup and view all the answers

What ratio describes the frequency of discoid lupus erythematosus (DLE) in females compared to males?

3:1 Signup and view all the answers

Lipsker’s new classification of LE cutaneous lesions relies on what primary factors?

Clinical characteristics and histopathological findings Signup and view all the answers

What is the significance of the terms acute, subacute, and chronic in the context of cutaneous lupus erythematosus?

They define the morphological variations of the lesions. Signup and view all the answers

What are the three categories used to classify specific lesions in lupus erythematosus?

ACLE, SCLE, and CCLE Signup and view all the answers

Which clinical criteria are specified for systemic lupus erythematosus according to SLICC 2012?

Oral or nasal ulcers Signup and view all the answers

What common feature is associated with the cutaneous manifestations of systemic lupus erythematosus?

Cytokine signaling Signup and view all the answers

Which of the following options corresponds with a clinical criterion under EULAR/ACR 2019?

Autoimmune hemolysis Signup and view all the answers

What type of lesions are associated with innate immune pathways in systemic lupus erythematosus?

Non-specific cutaneous manifestations Signup and view all the answers

Which of the following is considered a specific criterion for systemic lupus erythematosus under ACR 1997?

Photosensitivity Signup and view all the answers

Which cytokine involvement is frequently noted in the context of cutaneous lupus lesions?

Pro-inflammatory cytokines Signup and view all the answers

What type of rash is not included under the classification criteria for systemic lupus erythematosus?

Psoriatic rash Signup and view all the answers

Which of the following options is a characteristic of non-specific lesions associated with systemic lupus erythematosus?

Variable skin manifestations Signup and view all the answers

In the classification criteria of SLICC 2012, what does 'non-cicatricial alopecia' refer to?

Temporary hair shedding Signup and view all the answers

Study Notes

Cutaneous Lupus Erythematosus Overview

Autoimmune disease characterized by cutaneous manifestations that may occur independently or as part of systemic lupus erythematosus (SLE).
Classified into acute, subacute, chronic, intermittent, and bullous subtypes; identification relies on clinical features and lab findings.
Environmental, genetic, and immunological factors contribute to the development of skin lesions in lupus.

Incidence and Demographics

Exclusive cutaneous lupus erythematosus (CLE) is 2-3 times more common than SLE; annual incidence in Europe and the US is approximately 4.3 per 100,000.
Predominantly affects females; incidence of adult SLE is 7-15 times higher in women, with a slightly less significant female predominance in isolated CLE.
Racial differences noted, with African-Americans experiencing a 5.4-fold higher risk for chronic cutaneous lupus erythematosus (CCLE) compared to Caucasians, and indigenous Māori in New Zealand showing a higher relative risk.

Age and Clinical Presentation

Peak incidence of SLE occurs in middle age but is later in men compared to women.
Exclusive CLE is more common between ages 20 and 40, with an average onset age of 43.
Skin lesions significantly impact quality of life due to their disfiguring nature and prevalence on exposed skin.

Classification and Diagnostic Criteria

Classification systems for SLE include ACR 1997, SLICC 2012, and EULAR/ACR 2019, each providing specific diagnostic criteria.
SLICC 2012 has the highest overall diagnostic accuracy, while ACR 1997 shows the greatest specificity.
Gilliam & Sontheimer's 1981 classification differentiates cutaneous lesions into specific and nonspecific, focusing on characteristics like the presence of dermo-epidermal interface dermatitis.

Etiopathogenesis

SLE and CLE are multifactorial diseases involving genetic predisposition and environmental triggers such as UV radiation, drugs, and tobacco.
Epigenetic factors initiated by environmental stimuli can lead to immune system activation.
Research on genetic factors related to CLE is ongoing; several polymorphisms and mutations have been linked to immune pathway dysregulation.

Histopathological Features

Interface dermatitis is a key feature but lacks specificity, appearing in various conditions like dermatomyositis and drug reactions.
Recent classifications allow more accurate diagnoses by recognizing that specific lesions may occur without mandatory interface dermatitis.

Impact on Quality of Life

Skin lesions cause significant morbidity due to chronic inflammation and disfiguration, affecting patients' self-esteem and social interactions.
Diagnostic criteria focus on lesion characteristics to improve treatment outcomes and allow more tailored interventions.

Implications for Future Research

Understanding the mechanisms behind disease progression and identifying therapeutic targets are key for developing more effective treatments for CLE and related conditions.

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Description

Explore the essential aspects of cutaneous lupus erythematosus, covering its etiopathogenesis, clinical manifestations, diagnostic methods, and therapeutic approaches. This review provides a comprehensive understanding for dermatology professionals and students alike. Stay updated with the latest findings from Anais Brasileiros de Dermatologia.