Podcast
Questions and Answers
What is the relative risk of the Māori population for the development of all CLE subtypes?
What is the relative risk of the Māori population for the development of all CLE subtypes?
In which age range is exclusive CLE most commonly found?
In which age range is exclusive CLE most commonly found?
Which parameter is assigned the highest score in the classification of DLE skin lesions?
Which parameter is assigned the highest score in the classification of DLE skin lesions?
What method was used by the task force to propose uniformity in the classification of CLE?
What method was used by the task force to propose uniformity in the classification of CLE?
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What is the primary cause of morbidity associated with LE skin lesions?
What is the primary cause of morbidity associated with LE skin lesions?
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What is the primary classification of cutaneous lupus erythematosus?
What is the primary classification of cutaneous lupus erythematosus?
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Which factor is NOT associated with the pathogenesis of skin lesions in lupus erythematosus?
Which factor is NOT associated with the pathogenesis of skin lesions in lupus erythematosus?
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Cutaneous lupus erythematosus can present as which of the following?
Cutaneous lupus erythematosus can present as which of the following?
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What has recent progress in understanding cutaneous lupus erythematosus targeted?
What has recent progress in understanding cutaneous lupus erythematosus targeted?
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Which type of cutaneous lupus is primarily identified through clinical features and histopathological findings?
Which type of cutaneous lupus is primarily identified through clinical features and histopathological findings?
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Which of the following is a non-specific cutaneous manifestation associated with systemic lupus erythematosus?
Which of the following is a non-specific cutaneous manifestation associated with systemic lupus erythematosus?
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Which aspect is crucial for the diagnosis of cutaneous lupus erythematosus?
Which aspect is crucial for the diagnosis of cutaneous lupus erythematosus?
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Systemic lupus erythematosus may exhibit which of the following symptoms?
Systemic lupus erythematosus may exhibit which of the following symptoms?
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What percentage sensitivity is ensured with a score of 5 or greater for classification as DLE?
What percentage sensitivity is ensured with a score of 5 or greater for classification as DLE?
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Which classification system provided the highest overall diagnostic accuracy for SLE?
Which classification system provided the highest overall diagnostic accuracy for SLE?
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What factor is NOT mentioned as contributing to the multifactorial nature of SLE and CLE?
What factor is NOT mentioned as contributing to the multifactorial nature of SLE and CLE?
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Which classification system was proposed in 1981 and focused on differentiating cutaneous lesions?
Which classification system was proposed in 1981 and focused on differentiating cutaneous lesions?
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Which classification criteria showed the highest specificity for SLE classification?
Which classification criteria showed the highest specificity for SLE classification?
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What classifies eczematous lesions according to the classification proposed by Gilliam & Sontheimer?
What classifies eczematous lesions according to the classification proposed by Gilliam & Sontheimer?
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Which environmental exposure is mentioned as a factor for triggering SLE and CLE?
Which environmental exposure is mentioned as a factor for triggering SLE and CLE?
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What aspect of genetic research in CLE is described as still incipient compared to SLE?
What aspect of genetic research in CLE is described as still incipient compared to SLE?
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What is the significance of identifying the subtypes of cutaneous lupus erythematosus (CLE)?
What is the significance of identifying the subtypes of cutaneous lupus erythematosus (CLE)?
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Which condition is NOT associated with interface dermatitis?
Which condition is NOT associated with interface dermatitis?
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How does the prevalence of systemic lupus erythematosus (SLE) in females compare to that of isolated cutaneous lupus erythematosus (CLE)?
How does the prevalence of systemic lupus erythematosus (SLE) in females compare to that of isolated cutaneous lupus erythematosus (CLE)?
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What is the annual incidence rate of exclusive CLE in Europe and the US?
What is the annual incidence rate of exclusive CLE in Europe and the US?
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Which racial group has the highest risk of chronic cutaneous lupus erythematosus (CCLE)?
Which racial group has the highest risk of chronic cutaneous lupus erythematosus (CCLE)?
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What ratio describes the frequency of discoid lupus erythematosus (DLE) in females compared to males?
What ratio describes the frequency of discoid lupus erythematosus (DLE) in females compared to males?
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Lipsker’s new classification of LE cutaneous lesions relies on what primary factors?
Lipsker’s new classification of LE cutaneous lesions relies on what primary factors?
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What is the significance of the terms acute, subacute, and chronic in the context of cutaneous lupus erythematosus?
What is the significance of the terms acute, subacute, and chronic in the context of cutaneous lupus erythematosus?
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What are the three categories used to classify specific lesions in lupus erythematosus?
What are the three categories used to classify specific lesions in lupus erythematosus?
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Which clinical criteria are specified for systemic lupus erythematosus according to SLICC 2012?
Which clinical criteria are specified for systemic lupus erythematosus according to SLICC 2012?
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What common feature is associated with the cutaneous manifestations of systemic lupus erythematosus?
What common feature is associated with the cutaneous manifestations of systemic lupus erythematosus?
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Which of the following options corresponds with a clinical criterion under EULAR/ACR 2019?
Which of the following options corresponds with a clinical criterion under EULAR/ACR 2019?
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What type of lesions are associated with innate immune pathways in systemic lupus erythematosus?
What type of lesions are associated with innate immune pathways in systemic lupus erythematosus?
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Which of the following is considered a specific criterion for systemic lupus erythematosus under ACR 1997?
Which of the following is considered a specific criterion for systemic lupus erythematosus under ACR 1997?
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Which cytokine involvement is frequently noted in the context of cutaneous lupus lesions?
Which cytokine involvement is frequently noted in the context of cutaneous lupus lesions?
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What type of rash is not included under the classification criteria for systemic lupus erythematosus?
What type of rash is not included under the classification criteria for systemic lupus erythematosus?
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Which of the following options is a characteristic of non-specific lesions associated with systemic lupus erythematosus?
Which of the following options is a characteristic of non-specific lesions associated with systemic lupus erythematosus?
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In the classification criteria of SLICC 2012, what does 'non-cicatricial alopecia' refer to?
In the classification criteria of SLICC 2012, what does 'non-cicatricial alopecia' refer to?
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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.
