The lesions are typically chronic scaly plaques on the face, scalp and ears. Dermoscopy of discoid lupus erythematosus request pdf. Discoid lupus erythematosus dle is a chronic variant of cutaneous lupus erythematosus characterized by welldefined erythematous plaques with scale, often predominantly featured on the face, ears, anterior neck, and scalp. It is characterised by persistent scaly, disklike plaques on scalp, face and ears that may cause pigmentary changes, scarring and hair loss. It is a chronic skin condition of sores with inflammation and scarring favoring the face, ears, and scalp and at times on other body areas. Discoid lupus erythematosus of the vulva r bilenchi, c. Discoid lupus erythematosus dle may develop on traumatized skin and also may arise at sites of a prior cutaneous eruption. It is relatively easy to diagnose and is also treatable.
Feb 22, 2016 discoid lupus erythematosus dle is a chronic photosensitive skin eruption which can be either localised or widespread. Discoid lupus discoid lupus erythematosus is a chronic autoimmune disease affecting the skin. Its diversity of clinical features is matched by the complexity of the factors genetic, hormonal, and environmental that cause it, and the array of autoantibodies with which it is associated. Cutaneous lupus erythematosus cle can be divided into 3 main subtypes. Common symptoms include painful and swollen joints, fever, chest pain, hair loss, mouth ulcers, swollen lymph nodes, feeling tired, and a red rash which is. Discoid lupus erythematosus dle is the most common form of cutaneous lupus erythematosus. The first and the foremost step in the treatment of discoid lupus erythematosus is to avoid exposure to sun as individuals with discoid lupus erythematosus can develop sunburns when exposed to sun. We describe a 41year old caucasian woman with bilateral vulvar dle. The disease called discoid lupus erythematosus only affects the skin, although similar discoid skin lesions can occur in the serious disease called systemic lupus erythematosus sle. Discoid lupus erythematosus dle and subacute cutaneous lupus erythematosus scle are variants of cutaneous lupus that may occur independently or as manifestations of systemic lupus erythematosus.
Discoid lupus erythematosus is confined to the skin and is not associated with symptoms from other organs. Discoid lupus affects only the skin and does not usually involve internal organs. Case report of discoid lupus erythematosus in association. More than half of patients with dle first present with scalp involvement. Discoid lupus erythematosus dle is a chronic cutaneous disease characterized by inflammatory plaques that, in the absence of prompt diagnosis and treatment, may lead to disfiguring scarring and skin atrophy.
It has a prolonged course and can have a considerable effect on quality of life. This medical condition is a form of autoimmune skin disorder. Lupus, in general, is a medical condition that causes your bodys immune system to attack. Affected horses develop areas of patchy erythema, crusting alopecia, and scaling on the face, ears, and neck. Lupus erythematosus is a chronic inflammatory autoimmune disease with a wide range of clinical manifestations ranging from an indolent chronic cutaneous form to a severe potentially lifethreatening disease, systemic lupus erythematosus discoid lupus erythematosus is a subphenotype of chronic cutaneous lupus erythematosus, characterised by scaly diskshaped plaques which may be localised. Discoid lupus erythematosus is an uncommon skin rash, usually made worse by exposure to sunlight. Pdf to determine the demographic data, clinical pattern and therapeutic.
Discoid lupus erythematosus following herpes zoster. Pdf download for biological therapies in the treatment of cutaneous lupus. Dle is different from systemic lupus erythematosus sle, the most common form of lupus, which can affect any part of the body. Symptoms vary between people and may be mild to severe. However, there is limited evidence for which treatments are most effective.
Subacute cutaneous lupus erythematosus sciencedirect. Pathology of discoid lupus erythematosus dr sampurna roy md. It has been described as part of systemic lupus erythematosus sle or in isolation in adults1. Lesions are often localized to the scalp and can result in permanent scarring, disfiguration, and irreversible alopecia. Discoid lupus erythematosus british association of. Discoid lupus erythematosus definition of discoid lupus. Discoid lupus pictures, symptoms, treatment, causes 2020. Dle most commonly occurs on the head and is characterized by welldefined inflammatory plaques that evolve into atrophic, disfiguring scars. Only about 10% of all patients with dle will go on to develop the multiorgan disease sle. We report the case of a 20yearold woman with a history of systemic lupus erythematosus sle and dle who developed a painful, multidermatomal, vesicular rash.
Introduction systemic lupus erythematosus sle is a multi system connective tissue disorder characterized by the presence of. Secukinumabinduced chronic discoid lupus erythematosus. Discoid lupus erythematosus following herpes zoster mdedge. Article information, pdf download for uncommon cutaneous manifestations of lupus. Pdf discoid lupus erythematosus dle is the most common form of chronic cutaneous lupus erythematosus. Lupus erythematosus le is a common autoimmune disease that manifests in systemic and cutaneous forms. The term lupus erythematosus is applied to a range of related disorders.
Lupus erythematosus may be of several types including discoid dle and systemic sle. Discoid lupus is less severe and less life threatening, but approximately 5% of the dle patients may develop the systemic type of lupus as well. Females are more often affected, and the disease is more common in african american women. Symptoms will be mostly in his nasal area but can also impact other areas of his face and head. Balance the severity of cutaneous lupus against the risks of therapy. Immunoglobulins are found in the skin in this autoimmune disease. We present a unique case of discoid lupus erythematosus in which cluster of differentiation 68 cd68 immunochemistry identified widely dispersed histiocytes. Backgound although multiple studies suggest a dysregulated tcell cytokine production in systemic lupus erythematosus, the cytokine profile in discoid lupus erythematosus dle lesions is unknown. At one end of the range is systemic lupus erythematosus, which can. The term discoid refers to a rash of distinct reddened patches covered with grayish brown scales that may appear on the face, neck, and scalp. Cutaneous lupus erythematosus 3 categories of lespecific skin diseases 1. Severe chronic blepharitis and scarring ectropion associated with discoid lupus erythematosus. Discoid lupus erythematosus dle is the most common chronic form of cutaneous lupus. The diagnosis is usually made by clinical examination.
The discoloration can be accompanied by ulcers and bleeding. The term cutaneous lupus erythematosus is applied to. Discoid lupus erythematosus is an uncommon skin rash. Other articles where discoid lupus erythematosus is discussed. Discoid lupus erythematosus in the nigerians jacyk. Discoid lupus erythematosus dle is one of several rashes that can occur in lupus. Skinvet clinic faq discoid lupus erythematosus veterinary.
The cause of lupus is unknown, and the disease usually takes one of two forms. The lesions of discoid lupus erythematosus dle are categorized as either localized presenting above the neck in the scalp, face, and ears, or generalized involving areas above and below the neck, often in the upper extremities. Discoid lupus erythematosus in the nigerians jacyk 1979. Systemic lupus erythematosus larissa lisnevskaia, grainne murphy, david isenberg systemic lupus erythematosus is a remarkable and challenging disorder. The primary cle subsets are discoid lupus erythematosus dle, subacute cutaneous lupus erythematosus scle, and acute cutaneous lupus erythematosus acle. The word discoid is referring to the lesions disk shape. In discoid lupus erythematosus, the alopecic area shows active inflammation with erythema, edema, scaling, and follicular plugging, as well as atrophy with variable degrees of telangiectasia and dyspigmentation. Dle discoid lupus collie nose what is discoid lupus. On the other hand, many sle patients may present symptoms of. Nov 28, 2019 discoid lupus erythematosus dle is a form of lupus that mainly affects your skin.
Early diagnosis and treatment of discoid lupus erythematosus. It is classified as either localised, affecting skin above the neck only, or generalised, affecting above and below the neck. Clinically, the lesions appear as diskshaped plaques surmounted by a white adherent scale that also involves the hair follicles. Discoid lupus erythematosus dle is a skin condition of dogs. Discoid cutaneous lupus erythematosus vca animal hospital. Aug 21, 2018 cutaneous lupus erythematosus cle can be divided into 3 main subtypes.
Dogs with dle develop crusting and scabbing of the skin, most commonly starting around the nose, as well as a loss of skin pigmentation in the affected area. Uncommon cutaneous manifestations of lupus erythematosus jm. Jan, 2012 untreated periocular discoid lupus erythematosus dle, though very rare, may lead to significant morbidity with lid deformities, trichiasis, and symblepharon formation. It has a characteristic clinical appearance consisting of red, scaly plaques with resulting pigmentary changes and scars. Oct 11, 2016 cutaneous lupus erythematosus 3 categories of lespecific skin diseases 1. Lupus, technically known as systemic lupus erythematosus sle, is an autoimmune disease in which the bodys immune system mistakenly attacks healthy tissue in many parts of the body. Untreated periocular discoid lupus erythematosus dle, though very rare, may lead to significant morbidity with lid deformities, trichiasis, and symblepharon formation. Discoid lupus erythematosus is a chronic dermatological disease that can lead to scarring, hair loss, and hyperpigmentation changes in skin if it is not treated early and promptly. Review of treatment for discoid lupus erythematosus. Discoid lupus erythematosus dle is a form of lupus erythematosus marked by chronic skin eruptions. Risk of systemic lupus erythematosus is approximately 5%.
Discoid lupus erythematosus an overview sciencedirect. Sunscreens, protective clothing and protective makeup including wig are helpful in preventing damage to the skin. Cutaneous lupus erythematosus cle is an autoimmune disease with various subsets and wideranging clinical manifestations. The skin around the nose may also look abnormal, and rarely, the. It presents with red, inflamed, coinshaped patches of skin with a scaling and crusty appearance, most often on the scalp, cheeks, and ears. Detection of type 1 cytokines in discoid lupus erythematosus. Background we report the clinical and histopathological features of discoid lupus erythematosus dle in a group of saudi patients, and provide a basic framework for a. The propensity of some patients progressing to systemic lupus should be given.
Jul 31, 2018 discoid lupus erythematosus is confined to the skin and is not associated with symptoms from other organs. About 5%10% of patients with discoid lupus erythematosus will progress to systemic lupus. Discoid lupus erythematosus in dogs dr robert hilton bvschons macvsc canine medicine cert. Dle lesions are commonly incited by trauma, infection, burns, dermatitis, and ultraviolet radiation. It typically causes a loss of color in the hairless, moist part of the nose. Acute cutaneous lupus erythematosus acle most commonly presents as symmetric erythema overlying the malar cheeks and nasal bridge with sparing of the nasolabial folds butterfly rash. Discoid lupus erythematosus an overview sciencedirect topics. It is also referred to as discoid lupus erythematosus. Epidemiology and socioeconomic impact of skin disease in lupus. Early recognition and treatment improves the prognosis. If you have discoid lupus, you may develop chronic. Treatment of alopecia in chronic cutaneous lupus erythematosus.
Clinical characteristics of each group are unique 8. Discoid lupus causes, symptoms and treatment patient. Lupus erythematosus le is a chronic, autoimmune disease that includes a broad spectrum of symptoms. Cutaneous lupus erythematosus cle is an autoimmune skin disease occurring in. Lupus is the latin word for wolf and has been used to name various skin diseases at least since the 10 th century. In fact, a 2016 study demonstrated that over one third of patients with cutaneous lupus met criteria for depression or anxiety with need for psychiatric intervention. It is confined to the skin and does not cause any systemic symptoms. Discoid lupus erythematosus dle is a relatively common form of chronic cutaneous lupus, although its presentation in children is rare.
Determining risk factors for developing systemic lupus erythematosus in patients with discoid lupus erythematosus. Request pdf dermoscopy of discoid lupus erythematosus summary background dermoscopy is useful in evaluating skin tumours, but its applicability also extends into the field of inflammatory skin. Sunscreens, protective clothing and protective makeup including wig. Druginduced scle and drug induced chronic cutaneous lupus. Le is included among the so called connective tissue diseases and is divided into one systemic form sle and one cutaneous form cle. Discoid lupus erythematosus is a rare skin disease in horses that is believed to be a variant of systemic lupus erythematosus. Discoid lupus erythematosus in dogs symptoms, causes. It gets its name from the coinshaped lesions it produces. Discoid lupus erythematosus sri lanka journal of child health.
The prevalence rates of systemic lupus erythematosus sle may vary within. Discoid lupus erythematosus, the most common form of chronic cutaneous lupus erythematosus, is a disease of great clinical importance, characterized by the presence of erythematous, atrophic and. Cutaneous discoid lupus areas showing depigmentation and erythema should be selected for biopsy, rather than areas of ulceration andor crusts. Discoid lupus erythematosus is the most common type of chronic cutaneous lupus ccle, an autoimmune skin condition on the lupus erythematosus spectrum of illnesses. A preponderance of females was noticed femalemale ratio of 5.
Aug 21, 2018 discoid lupus erythematosus is known to negatively impact patient quality of life. Article information, pdf download for epidemiology and socioeconomic impact. A more severe form is called systemic lupus erythematosus sle, which can affect internal organs. Discoid lupus erythematosus dle is a common autoimmune skin condition in dogs. Clinically, the lesions appear as diskshaped plaques surmounted by a. Discoid lupus can cause permanent scarring if it is not treated or if treatment is not effective. Microsoft powerpoint discoid lupus erythematosus in dogs.
Recently, it was also described with interleukin il 17 inhibition. At one end of the range is systemic lupus erythematosus, which can damage internal organs, whilst right at the other end of the range is discoid lupus erythematosus, which is confined to the skin and does not cause general ill health. Genital involvement is a rare manifestation in discoid lupus erythematosus dle and systemic lupus erythematosus sle, and there are few reports on vulvar clinical features. Biological therapies in the treatment of cutaneous lupus. The histologic profile of discoid lupus erythematosus typically involves a vacuolar interface reaction with an associated superficial and deep perivascular infiltrate composed of lymphoplasmacytes. Objectives to characterize the cytokine profile in dle by immunohistochemical and molecular methods, and to investigate the role of cytokines in the. Discoid lupus is an autoimmune disease where the immune system attacks the skin. Importance discoid lupus erythematosus dle is a chronic variant of cutaneous lupus erythematosus, an autoimmune inflammatory disorder of the skin. Dle can cause permanent scarring if treatment is inadequate. We report a case of severe haemolytic anaemia with discoid lesions. Patients with chronic discoid lupus erythematosus constituted 046% of all out. The typical presentation of dle is wellcircumscribed, indurated, sometimes scaly round or oval plaques with pigmentary change, often red to purple in color.
Gilliam recognized subacute cutaneous lupus erythematosus scle as a lupus specific eruption that identifies a unique subset of lupus erythematosus. Aug 30, 2017 discoid lupus discoid lupus erythematosus is a chronic autoimmune disease affecting the skin. Cutaneous manifestations of lupus erythematosus le are, usually. Although dle usually responds to topical or intralesional corticosteroids andor oral antimalarials, some dle is resistant to.
Discoid lupus erythematosus dle is an inflammatory autoimmune disease leading to scarring and hair loss. Discoid lupus erythematosus dle is a chronic skin condition that occurs in the face, ears. Discoid lupus erythematosus dle, also known as cutaneous lupus erythematosus, is an autoimmune disease that affects the skin, in which the bodys own immune system is activated to attack the body. Discoid lupus erythematosus dle is a disfiguring autoimmune skin disease and the most common form of chronic cutaneous lupus erythematosus. The isomorphic response is the appearance of new lesions from a preexisting skin condition at a site of trauma. Lupus erythematosus le is a group of diverse, persistent inflammatory autoimmune diseases and often affects the skin. Backgound although multiple studies suggest a dysregulated tcell cytokine production in systemic lupus erythematosus, the cytokine profile in discoid lupus erythematosus dle lesions is unknown objectives to characterize the cytokine profile in dle by immunohistochemical and molecular methods, and to investigate the role of cytokines in the pathogenesis of dle. Download as pptx, pdf, txt or read online from scribd. Here, we report the case of a 39yearold man with onset of cutaneous discoid lupus erythematosus during subcutaneous administration of the il17a. Druginduced lupus erythematosus is a rare adverse event of biological treatment, mainly observed with tumor necrosis factor. Review of treatment for discoid lupus erythematosus garza. Discoid lupus symptoms, diagnosis, treatments and causes.
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