Lesions may be part of systemic lupus or may represent discoid lupus without organ involvement, which is a separate diagnostic entity. Lupus erythematosus le comprises an uncommon group of connective tissue disorders. A number of candidate genes have been identified which increase the risk. Discoid lupus erythematosus dle is a chronic photosensitive skin eruption which can be either localised or widespread. Lesions in the oral cavity may be present in each of these two types of lupus erythematosus. Aug 10, 2015 the pathophysiology of cutaneous lupus erythematosus cle encompasses the complex interactions between genetics, the environment, and cells and their products. Discoid lupus erythematosus dle is a form of chronic cutaneous lupus erythematosus characterized by hyperkeratotic inflammatory plaques which eventuate into. It is characterised by persistent scaly, disklike plaques on scalp, face and ears that may cause pigmentary changes, scarring and hair loss. The pathophysiology of cutaneous lupus erythematosus cle encompasses the complex interactions between genetics, the environment, and cells and their products. Dle most commonly occurs on the head and is characterized by welldefined inflammatory plaques that evolve into atrophic, disfiguring scars.
It is confined to the skin and does not cause any systemic symptoms. Discoid lupus erythematosus dle is the most common form of chronic cutaneous lupus erythematosus. Severe chronic blepharitis and scarring ectropion associated with discoid lupus erythematosus. Aug 21, 2018 cutaneous lupus erythematosus cle can be divided into 3 main subtypes. Discoid lupus affects only the skin and does not usually involve internal organs. 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. Discoid lupus erythematosus causes currently, the cause of why dle is being experienced by some is still unknown or idiopathic in nature. Lupus erythematosus le is a group of diverse, persistent inflammatory autoimmune diseases and often affects the skin. It was first described in dogs by griffin and colleagues in 1979. Discoid lupus erythematosus cutaneous lupus erythematosus.
Discoid lupus erythematosus dle, a chronic dermatological disease, is the most common form of chronic cle. 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. Only about 10% of all patients with dle will go on to develop the multiorgan disease sle. On the other hand, many sle patients may present symptoms of discoid disease. Discoid lupus erythematosus dle is the most common form of cutaneous lupus erythematosus. 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.
Discoid cutaneous lupus erythematosus vca animal hospital. Discoid lupus erythematosus pictures, treatment, symptoms. Discoid lupus erythematosus dle is one of several rashes that can occur in lupus. Discoid rash erythematosus raised patches with adherent.
Discoid lupus erythematosus dle is a disease in which coinshaped discoid red bumps appear on the skin. The lesion of discoid lupus erythematosus is usually clinically characteristic. However, the exact etiology of discoid lupus erythematosus dle is not well understood. Discoid lupus erythematosus is the most common type of chronic cutaneous lupus ccle, an autoimmune skin condition on the lupus erythematosus spectrum of illnesses. Discoid lupus discoid lupus erythematosus is a chronic autoimmune disease affecting the skin. Chronic cutaneous lupus erythematosus chronic cutaneous lupus erythematosus ccle is more common in women, affecting from 1.
The typical presentation of dle is wellcircumscribed, indurated, sometimes scaly round or oval plaques with pigmentary change, often red to purple in color. Aug 21, 2018 lupus erythematosus is a polygenic autoimmune disease linked to various hla subtypes, immune signaling, and environmental factors, which ultimately leads to autoantibody production and tcell dysfunction. Most common form of chronic cutaneous lupus erythematosus. The center areas may appear lighter in color surrounded by an area darker than the normal skin. Cutaneus discoid lupus erythematosus cdle merupakan penyakit autoimun sistemik dengan penyebab multifaktor, yang ditandai keterlibatan beberapa organ dan sistem oleh karena kelainan imunologi. The surface of the nose becomes smooth gray, and ulcerated, instead. Lupus erythematosus profundus is the preferred terminology for lesions of lupus erythematosus panniculitis that have overlying changes of discoid lupus, namely vacuolar interface dermatitis, basement membrane thickening, scale, follicular plugging and both perifollicular and periadnexal inflammation. Lupus erythematosus is a polygenic autoimmune disease linked to various hla subtypes, immune signaling, and environmental factors, which ultimately leads to autoantibody production and tcell dysfunction. A number of candidate genes have been identified which increase the risk of developing cle. Manifestasi klinis cdle bervariasi dan melibatkan banyak organ baik beberapa organ berbeda maupun berkaitan selama periode penyakit berlangsung. Cutaneous lupus erythematosus clinical and laboratory. Eventually, the color deepens and the plaques become edematous with elevation fig. It gets its name from the coinshaped lesions it produces. Lupus erythematosus le is a chronic, autoimmune disease that includes a broad spectrum of symptoms.
About 5%10% of patients with discoid lupus erythematosus will progress to systemic lupus. 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. The center areas may appear lighter in color with a rim darker than the normal skin. Discoid lupus erythematosus can be categorized into localized, generalized, and childhood dle 1. The only known information about dle is that it is an autoimmune kind of disorder, i.
The skin is one of the target organs most variably affected by the disease. Discoid lupus erythematosus an overview sciencedirect topics. Dle generally represents the benign pole of the le spectrum. Pathology of discoid lupus erythematosus dr sampurna roy md. Discoid lupus erythematosus dle is a chronic skin condition of sores with inflammation and scarring favoring the face, ears, and scalp and at times on other body areas. This is found in up to 90 percent of affected dogs. The third feature may be discoid rash sensitivity 18%. The main types of lupus are discoid lupus erythematosus dle, subacute cutaneous lupus erythematosus scle and systemic lupus erythematosus. They develop as an inflamed growth with scaling and a warty like appearance. Aug 30, 2017 discoid lupus discoid lupus erythematosus is a chronic autoimmune disease affecting the skin. You can help by taking up membership for more information contact. The lesions are typically chronic scaly plaques on the face, scalp and ears. Oct 29, 2017 discoid lupus erythematosus mainly affects skin that is exposed to sunlight and doesnt typically affect vital internal organs. Discoid lupus erythematosus symptoms, diagnosis and.
Lupus erythematosus induced by medications, ultraviolet radiation, and other exogenous agents. The cause of lupus is unknown, and the disease usually takes one of two forms. These lesions develop as a red, inflamed patch with a scaling and crusty appearance. Lupus erythematosus may be of several types including discoid dle and systemic 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. The discoloration can be accompanied by ulcers and bleeding. Recent data have provided enhanced understanding of these interactions and the mechanism by which they cause disease.
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. Discoid lupus erythematosus at the vermilion border of the. Classic lupus is also termed systemic lupus erythematosus and typically initially appears as a rash accompanied by joint pain and fever. Canine discoid lupus erythematosus showing loss of noseprint, depigmentation, ulceration and tissue destruction all characteristic of the syndrome. 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. Dle can cause permanent scarring if treatment is inadequate. The term lupus erythematosus is applied to a range of related disorders. 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. Immunoglobulins are found in the skin in this autoimmune disease. 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. It often begins as an erythematous papule or plaque with scale fig.
Cutaneous lupus erythematosus cutaneous le includes three subsets of lespecific skin diseases. Chronic cutaneous lupus erythematosus discoid lupus erythematosus dle. Discoid lupus erythematosus definition of discoid lupus. Ccle encompasses discoid lupus erythematosus dle, lupus erythematosus tumidus le tumidus. Discoid lupus erythematosus chronic lesions skin site. Discoid lesions are the most common skin manifestations of ccle. Lupus is a general term that refers to any of the various chronic inflammatory diseases that are marked by inflammation of the skin and are caused by autoimmunity.
The aim of this chapter, which is set out as below, is to highlight the key features of these conditions. Discoid lupus erythematosus british association of. Discoid lupus erythematosus dle is a relatively common form of chronic cutaneous lupus, although its presentation in children is rare. At one end of the range is systemic lupus erythematosus, which can. Systemic lupus erythematosus sle is a multiorgan autoimmune disease of unknown etiology with many clinical manifestations. Affected horses develop areas of patchy erythema, crusting alopecia, and scaling on the face, ears, and neck. Lupus erythematosus primary care dermatology society uk.
The skin around the nose may also look abnormal, and rarely, the. Dle discoid lupus collie nose what is discoid lupus. The lupus erythematosus is described as having two distinct forms. Lesions precede the onset of systemic symptoms in 25 percent of patients, many of whom present to dermatologists for their initial evaluation. Feb 22, 2016 discoid lupus erythematosus dle is a chronic photosensitive skin eruption which can be either localised or widespread. Cutaneous lupus erythematosus cle is the second most common presenting symptom of autoimmune lupus erythematosus le.
May 11, 2017 discoid lupus erythematosus dle is a form of chronic cutaneous lupus erythematosus characterized by hyperkeratotic inflammatory plaques which eventuate into areas of scarring. Discoid lupus erythematosus is an uncommon skin rash, usually made worse by exposure to sunlight. Discoid lupus erythematosus dle is a chronic skin condition that develops circular inflamed red patches with a scaling and crusty appearance, ranging from 510 mm in diameter. Discoid lupus erythematosus dle is the most common chronic form of cutaneous lupus. Discoid lupus erythematosus is a rare skin disease in horses that is believed to be a variant of systemic lupus erythematosus. Discoid lupus erythematosus investigations bmj best practice. 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. Cutaneous manifestations of systemic lupus erythematosus. Z, and the scale may thicken and become adherent fig. Telangiectoid variant of discoid lupus erythematosus the telangiectoid variant of dle is extremely rare, consisting of purplish plaques or blotchy reticulate telangiectasia that may develop on the face, neck, ears, dorsal aspects of the hands, breast, front of the knees, and back of the heels or sides of feet fig. Risk of systemic lupus erythematosus is approximately 5%. Pathology outlines lupus erythematosus panniculitis. The sores are usually located on the face, ears and scalp.
Lupus is the latin word for wolf and has been used to name various skin diseases at least since the 10 th century. Lesions are welldemarcated erythematous macules or papules with a scaly surface, which frequently evolve into larger coinshaped plaques. In this case, no laboratory or other known systemic abnor mality was evident on clinical examination other than. Pathophysiology of cutaneous lupus erythematosus arthritis.
Le is included among the so called connective tissue diseases and is divided into one systemic form sle and one cutaneous. Cutaneous lupus erythematosus cle can be divided into 3 main subtypes. Discoid lupus erythematosus definition discoid lupus erythematosus dle is a disease in which coinshaped discoid red bumps appear on the skin. Discoid lupus erythematosus investigations bmj best. Disease severity is wide ranging, with most suffering milder. Description 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. It presents with red, inflamed, coinshaped patches of skin with a scaling and crusty appearance, most often on the scalp, cheeks, and ears. It has a characteristic clinical appearance consisting of red, scaly plaques with resulting pigmentary changes and scars. 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.
Discoid lupus erythematosus dle is a skin condition of dogs. Discoid lupus erythematosus, also known as chronic cutaneous le, consists of cutaneous lesions, usually without evidence of systemic manifestations. It typically causes a loss of color in the hairless, moist part of the nose. Discoid rash raised erythematous patches with keratotic scaling, follicular plugging, and atrophic scarring 3. Discoid or cutaneous lupus refers to symptoms affecting the skin. Discoid lupus erythematosus dle is an uncommon autoimmune disease of the basal cell layer of the skin. Discoid lupus erythematosus american osteopathic college.
Discoid lupus erythematosus is a chronic skin condition characterized by inflammation and scarring type skin lesions which occur on the face, ears, scalp and at times on other body areas. 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. Understanding discoid or cutaneous lupus erythematosus. Discoid lupus erythematosus an overview sciencedirect. Discoid lupus erythematosus dle is a chronic autoimmune skin condition characterized by erythematous lesions with scaly and crusty appearances. Discoid lupus erythematosus dle is a disfiguring autoimmune skin disease and the most common form of chronic cutaneous lupus erythematosus. Sunscreens, protective clothing and protective makeup including wig are helpful in preventing damage to the skin. Pdf cutaneous manifestations of systemic lupus erythematosus. The american college of rheumatology acr established 11 criteria as a classificatory instrument to operationalise the definition of sle in clinical trials. Ethnic differences in the clinical expression of systemic lupus erythematosus. Discoid or cutaneous skin lupus erythematosus systemic lupus erythematosus sle druginduced erythematosus neonatal lupus. Other articles where discoid lupus erythematosus is discussed. It occurs in humans and cats, more frequently occurring in dogs. Classic dle lesions begin as redpurple macules, papules or small plaques and rapidly develop a.
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. Laporan kasus cutaneus discoid lupus erythematosus. Dle lesions begin as welldemarcated erythematous macules or papules with a scaly surface, and frequently evolve into larger coinshaped plaques. The most common initial symptom is scaling and loss of pigment on the nose. The relationship between discoid and systemic lupus. The relationship between discoid and systemic lupus erythematosus. Discoid lupus erythematosus dle is a chronic inflammatory condition of the skin.
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