Discoid lupus erythematosus is an autoimmune disease which occurs in genetically predisposed individuals. What is discoid lupus erythematosus lupus erythematosus le is a group of diverse, persistent inflammatory autoimmune diseases and often affects the skin. Discoid lupus erythematosus british association of. It does not progress to systemic lupus erythematosus sle in dogs. It is characterised by persistent scaly, disklike plaques on scalp, face and ears that may cause pigmentary changes, scarring and hair loss. In this case report, the authors describe a variant of discoid lupus erythematosus dle limited to the skin in a 9yearold chinese crested dog. There are no fda approved therapies for cle, and these. Cutaneous lupus erythematosus cle is a common manifestation among systemic lupus patients. Lupus uk is the national charity caring for those with systemic lupus erythematosus sle and discoid lupus erythematosus dle, supporting people as they develop the symptoms prior to diagnosis and those already diagnosed.
Discoid lupus erythematosus is a rare skin disease in horses that is believed to be a variant of systemic lupus erythematosus. Hippocrates was the first to document symptoms consistent with that of lupus erythematosus in the year 400 bc. Cutaneous manifestations of systemic lupus erythematosus. Le is included among the so called connective tissue diseases and is divided into one systemic form sle and one cutaneous form cle. Do you know how to distinguish sle from other conditions with similar clinical characteristics. Importance discoid lupus erythematosus dle is a chronic variant of cutaneous lupus erythematosus, an autoimmune inflammatory disorder of the skin. Discoid lupus erythematosus dle is one of several rashes that can occur in lupus. It is classified as either localised, affecting skin above the neck only, or generalised, affecting above and below the neck. Discoid lupus erythematosus dle is a skin condition of dogs. Rheumatologists sometimes use specific criteria cdcpdf pdf 510kbexternal to classify sle for research purposes. Immunoglobulins are found in the skin in this autoimmune disease. Risk of systemic lupus erythematosus is approximately 5%. Previous research on cutaneous lupus erythematosus lesions has been directed at examining the relationship between the scarring lesions of discoid lupus erythematosus dle and systemic lupus erythematosus sle and the pathogenesis of the lesions of cutaneous lupus erythematosus. Dle discoid lupus collie nose what is discoid lupus.
Our objective was to update the eular recommendations for the management of systemic lupus erythematosus sle, based on emerging new evidence. Discoid lupus erythematosus is an uncommon skin rash, usually made worse by exposure to sunlight. Early recognition and treatment improves the prognosis. Sclerodermic lep slep, first coined by marzano in 2005 to describe this entity, has only been noted in 4 patients. Understanding discoid or cutaneous lupus erythematosus. Discoid lupus erythematosus dle is the most common chronic form of cutaneous lupus.
Many physicians have studied and added to the current day knowledge of lupus erythematosus. However, approximately 10 percent of people who have discoid lupus may develop sle systemic lupus erythematosus. The history of lupus erythematosus is divided into three categories. It occurs in humans and cats, more frequently occurring in dogs. Draft guideline systemic lupus erythematosus sle european. Affected horses develop areas of patchy erythema, crusting alopecia, and scaling on the face, ears, and neck. 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. Lupus is the latin word for wolf and has been used to name various skin diseases at least since the 10 th century. The patient also had conconcomitant discoid lupus erythematosus dle with a similar pattern sclerodermalike fibrosis, ie, sclerodermic dle. Discoid lupus erythematosus an overview sciencedirect. Results of a detailed clinical and laboratory study of 37 nigerian patients with chronic discoid lupus erythematosus are presented. Clinical practice guideline on systemic lupus erythematosus. Discoid cutaneous lupus erythematosus vca animal hospital. 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.
The discoid lupus erythematosus treatment includes sunscreens, steroids and antimalarial medications. Successful treatment of generalized discoid lupus erythematosus with imiquimod cream 5%. Clinically, the lesions appear as diskshaped plaques surmounted by a. Dermoscopic features of discoid lupus erythematosus dle depend on the stage of the lesions. Treatment in sle aims at remission or low disease activity and. Dle lesions begin as welldemarcated erythematous macules or papules with a scaly surface, and frequently evolve into larger coinshaped plaques. Cutaneous lupus erythematosus in a linear configuration is rare, especially in children. Discoid lupus erythematosus in dogs dr robert hilton bvschons macvsc canine medicine cert. Many drugs have been used to treat this disease and some such as thalidomide, cyclophosphamide and azathioprine are potentially toxic. Discoid lupus is an uncommon but longlasting chronic skin rash, which is usually made worse by exposure to sunlight it is photosensitive. This condition causes a severe rash that tends to get worse when exposed to sunlight. Physical activity and sedentary behavior in patients with.
Discoid lupus erythematosus of the eyelids harvey siy uy, md introduction. Systemic lupus erythematosus sle is a multiorgan autoimmune disease of unknown etiology that can have many clinical manifestations table 1. Lupus erythematosus le is a chronic, autoimmune, multisystem disease that displays many diverse symptoms in which localized cutaneous le cle is on. New horizons in the genetic etiology of systemic lupus. Systemic lupus erythematosus sle is the prototypic multisystem autoimmune disorder with a broad spectrum of clinical presentations. Discoid lupus erythematosus dle is a chronic inflammatory condition of the skin. Systemic lupus erythematosus sle is an autoimmune disease with a prevalence of 36. General management of systemic lupus erythematosus. Omim 152700 is a complex autoimmune disease not only from a clinical standpoint but also from genetic. Discoid lupus erythematosus dle is a chronic photosensitive skin eruption which can be either localised or widespread. The lesions are typically chronic scaly plaques on the face, scalp and ears. Sle is an autoimmune disease in which the immune system attacks its own tissues, causing widespread inflammation and tissue damage in the affected organs.
Discoid lupus erythematosus dle is a chronic inflammatory erythematous skin disease that can be triggered by several factors. 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. Guideline on clinical investigation of medicinal products. Dermoscopy of discoid lupus erythematosus request pdf. Systemic lupus erythematosus sle, a multisystem autoimmune disorder occurring predominantly in women of reproductive age, has diverse clinical manifestations and is often difficult to diagnose. The most common and severe form is systemic lupus erythematosus. It gets its name from the coinshaped lesions it produces. Rosacea is another skin disease that causes facial redness and tenderne.
Sle can also have skin symptoms, but it appears that the two are either separate diseases or dle is a mild form of sle. Discoid or cutaneous lupus refers to symptoms affecting the skin. Discoid lupus erythematosus is the most common type of chronic cutaneous lupus ccle, an autoimmune skin condition on the lupus erythematosus spectrum of illnesses. Lupus erythematosus is a collection of autoimmune diseases in which the human immune system becomes hyperactive and attacks healthy tissues. Discoid lupus erythematosus dle is the most common form of cutaneous lupus erythematosus. This form of lupus is typically limited to the skin. The skin is involved in up to 85% of systemic lupus erythematosus sle cases and may be the only organ involved in cutaneous lupus erythematosus cle. Pdf cutaneous lupus erythematosus issues in diagnosis. The relationship between discoid and systemic lupus.
Discoid lupus discoid lupus erythematosus is a chronic autoimmune disease affecting the skin. The dog had a 9month history of progressive skin disease characterized by annular to polycyclic, hyperpigmented, scaly to erythematous lesions. Early diagnosis and treatment of discoid lupus erythematosus. Sle patients were consecutively enrolled in a cross sectional study. The skin around the nose may also look abnormal, and rarely.
Patients with chronic discoid lupus erythematosus constituted 046% of all out. The term lupus erythematosus is applied to a range of related disorders. Pathology of discoid lupus erythematosus dr sampurna roy md. Turan e, sinem bagci i, turgut erdemir a, salih gurel m. It has a prolonged course and can have a considerable effect on quality of life. The diagnosis and treatment of systemic lupus erythematosus. 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. You can help by taking up membership for more information contact. 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. Systemic lupus erythematosus sle, is the most common type of lupus. Linear cutaneous lupus erythematosus following the lines. Treatment of alopecia in chronic cutaneous lupus erythematosus. While the face, trunk and extremities are frequently affected, eyelid involvement is uncommon and often presents as a diagnostic problem. Also discoid lupus erythematosus can progress to systemic lupus erythematosus.
American college of rheumatology classification criteria for. Discoid lupus erythematosus in the nigerians jacyk. Dle most commonly occurs on the head and is characterized by welldefined inflammatory plaques that evolve into atrophic, disfiguring scars. The clinical course is variable, with a broad spectrum of organ manifestations. Discoid rash raised erythematous patches with keratotic scaling, follicular plugging, and atrophic scarring 3. To develop new classification criteria for systemic lupus erythematosus sle jointly supported by the. The diagnosis is usually made by clinical examination. Symptoms of these diseases can affect many different body systems, including joints, skin, kidneys, blood cells, heart, and lungs. Discoid lupus can be localised to affect a small area of skin, or may be more widespread. The term is also used for localized cutaneous lesions such as those seen in discoid lupus erythematosus dle, lupus erythematosus profundus and subacute. Katarzyna gilekseibert, md abstract systemic lupus erythematosus sle is a chronic, compli. Discoid lupus causes, symptoms and treatment patient.
Discoid lupus erythematosus successfully treated by photodynamic therapy. Discoid lupus erythematosus symptoms, diagnosis and. It is confined to the skin and does not cause any systemic symptoms. Discoid lupus is also called discoid lupus erythematosus dle. It presents with red, inflamed, coinshaped patches of skin with a scaling and crusty appearance, most often on the scalp, cheeks, and ears. Lupus erythematosus le is a chronic, autoimmune disease that includes a broad spectrum of symptoms. Discoid lupus erythematosus involving the eyelids article in journal of the european academy of dermatology and venereology 191. 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. Lesions are often localized to the scalp and can result in permanent scarring, disfiguration, and irreversible alopecia.
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