Table 1.
LE Specific Skin Disease
| CLE Subtype | Clinical Characteristics |
|---|---|
| ACLE | 30–50% patients with SLE. Flares often parallel systemic disease activity. Can see +ANA, +anti-dsDNA, +anti-Smith |
| • Localized | Raised or flat malar rash. Photosensitive, non-scarring, transient. |
| • Generalized | Widespread maculopapular rash above and below the neck. Dorsum of hands sparing MCP and IP joints. Photosensitive, pruritic. |
| • TEN-like | Widespread denudation and blistering on sun exposed areas |
| SCLE | Recurrent course of widespread, highly photosensitive lesions that resolve without scarring though dyspigmentation may occur. 10–15% patients have SLE with arthralgias/myalgias, rare internal organ involvement. Often +ANA, +SSA. 1/3 cases drug induced |
| • Annular | Scaly annular erythematous plaques often merge to polycyclic morphology |
| • Papulosquamous | Resembles psoriasis or eczema |
| • Erythrodermic | Generalized exfoliative erythroderma |
| CCLE | Chronic, recurrent disease course. Rates of SLE vary between subtypes |
| • DLE | Erythematous, sometimes scaly plaques exacerbated by sun-exposure and trauma, progress to dyspigmentation and atrophic scarring. Localized if confined to head and neck. Generalized if extends below neck. |
| • Hypertrophic | Papular lesions on face, extensor surfaces, palms/soles |
| • Mucosal | Erosions and macules on mucosal surfaces |
| • LEP | Indurated subcutaneous nodules or plaques in face, scalp, upper torso, buttocks, proximal extremities. Atrophic scars. |
| • CHLE | Painful violaceous plaques and nodules in cold-exposed areas, may progress to erosions or ulcerations on acral surfaces |
| • LET | Erythematous macules, papules, plaques with smooth surfaces and no scale, sharp raised borders. Very photosensitive. |
Abbreviations: LE, lupus erythematosus; CLE, cutaneous lupus erythematosus; ACLE, acute cutaneous lupus erythematosus; TEN, toxic epidermal necrolysis; SCLE, subacute cutaneous lupus erythematosus; CCLE, chronic cutaneous lupus erythematosus; DLE, discoid lupus erythematosus; LEP, lupus erythematosus panniculitis; CHLE, chilblain lupus erythematosus; LET, lupus erythematosus tumidus