[Classification of dermatologic manifestations in lupus erythematosus].
Various dermatologic manifestations are observed in the different lupus subsets. Lupus lesions are characterized by a dermo-epidermal dermatitis. Other lesions, vascular or non vascular, are essentially present in association with systemic lupus erythematosus. Acute, subacute and chronic lupus erythematosus are distinguishable according to their clinical aspects, pathological features and evolution. Acute lesions are either localized to the midface or widespread. Subacute lesions may be annular or psoriasiform. Chronic lupus erythematosus includes localized or widespread discoid lupus, lupus tumidus, chilblain lupus and panniculitis. Therapy of cutaneous lupus is mainly based on antimalarials and avoidance of sun irradiation. In refractory cutaneous lupus, no universal guidelines are currently available. Except for acrosyndromes and urticaria-like lesions, vascular lesions may be due to vasculitis or thrombosis. An accurate diagnosis is absolutely necessary since therapy is different in thrombosis and vasculitis. Non vascular and non lupus lesions are numerous, some of them require special treatment such as dapsone for bullous lupus.
Francès
Camille
C
Service de Médecine Interne, Hôpital de la Pitié, 83, boulevard de l'Hôpital, 75651 Paris Cedex 13. camille.frances@psl.ap-hop-paris.fr
Barete
Stéphane
S
Ayoub
Nakhle
N
Piette
Jean-Charles
JC
D017255:Acitretin / Q000008:administration & dosage / Q000627:therapeutic use; D000305:Adrenal Cortex Hormones / Q000627:therapeutic use; D000328:Adult; D000962:Antimalarials / Q000627:therapeutic use; D002986:Clinical Trials as Topic; D003622:Dapsone / Q000008:administration & dosage / Q000627:therapeutic use; D003879:Dermatologic Agents / Q000627:therapeutic use; D003937:Diagnosis, Differential; D004338:Drug Combinations; D005260:Female; D005944:Glucosamine / Q000008:administration & dosage / Q000031:analogs & derivatives* / Q000627:therapeutic use; D006801:Humans; D006886:Hydroxychloroquine / Q000008:administration & dosage / Q000627:therapeutic use; D007166:Immunosuppressive Agents / Q000627:therapeutic use; D007231:Infant, Newborn; D015474:Isotretinoin / Q000008:administration & dosage / Q000627:therapeutic use; D007641:Keratolytic Agents / Q000008:administration & dosage / Q000627:therapeutic use; D008178:Lupus Erythematosus, Cutaneous / Q000145:classification / Q000175:diagnosis / Q000188:drug therapy / Q000473:pathology / Q000628:therapy; D008179:Lupus Erythematosus, Discoid / Q000175:diagnosis; D008297:Male; D008875:Middle Aged; D012867:Skin / Q000473:pathology; D012460:Sulfasalazine / Q000008:administration & dosage / Q000627:therapeutic use; D013792:Thalidomide / Q000008:administration & dosage / Q000627:therapeutic use; D013927:Thrombosis / Q000175:diagnosis / Q000473:pathology; D014467:Ultraviolet Therapy; D014657:Vasculitis / Q000175:diagnosis / Q000473:pathology
D000305:Adrenal Cortex Hormones; D000962:Antimalarials; D003879:Dermatologic Agents; D004338:Drug Combinations; D007166:Immunosuppressive Agents; D007641:Keratolytic Agents; C028423:Salazopyrine; D012460:Sulfasalazine; D006886:Hydroxychloroquine; D013792:Thalidomide; D003622:Dapsone; D015474:Isotretinoin; D017255:Acitretin; D005944:Glucosamine