Subacute cutaneous lupus erythematosus. Clinical, serologic, immunogenetic, and therapeutic considerations in seventy-two patients.
We studied 72 patients with subacute cutaneous lupus erythematosus (SCLE). Forty-nine of the patients had been part of an earlier study. The cutaneous disease was primarily annular in 17 patients, papulosquamous in 48, and a combination in 7. Although the major feature of SCLE is nonscarring, non-atrophy-producing lesions, scarring discoid lesions were observed in 21 patients. Thirty-six patients fulfilled criteria for systemic lupus erythematosus. Cytoplasmic antibodies were present in only 22 patients. However, in the group of 23 patients recently analyzed, 13 of 22 tested had anti-Ro (SS-A) and/or anti-La (SS-B). HLA-DR3 was present in 22 of 59 patients. Neither anti-Ro (SS-A) nor HLA-DR3 correlated with any clinical finding. Forty-seven patients have had continued activity of their disease, but in most patients, the disease has been controlled with sunscreens, topical and intralesional corticosteroids, and oral hydroxychloroquine. A broad spectrum of systemic lupus erythematosus-associated phenomena can occur in patients with SCLE. The disease is frequently easily controlled, and may become quiescent. This subset of lupus patients is less distinctive than has been previously suggested.
Callen
J P
JP
University of Louisville School of Medicine, Kentucky.
Klein
J
J
D000305:Adrenal Cortex Hormones / Q000627:therapeutic use; D000328:Adult; D000974:Antibodies, Antinuclear / Q000032:analysis*; D005260:Female; D006681:HLA-D Antigens / Q000032:analysis*; D006684:HLA-DR Antigens / Q000032:analysis*; D015803:HLA-DR3 Antigen; D006801:Humans; D006886:Hydroxychloroquine / Q000627:therapeutic use; D008178:Lupus Erythematosus, Cutaneous / Q000175:diagnosis / Q000188:drug therapy / Q000276:immunology; D008297:Male; D013473:Sunscreening Agents / Q000627:therapeutic use
D000305:Adrenal Cortex Hormones; D000974:Antibodies, Antinuclear; D006681:HLA-D Antigens; D006684:HLA-DR Antigens; D015803:HLA-DR3 Antigen; C035356:SS-A antibodies; C035357:SS-B antibodies; D013473:Sunscreening Agents; D006886:Hydroxychloroquine