[Cutaneous lupus erythematosus. Part 2: diagnostics and therapy].
The diagnosis of cutaneous lupus erythematosus (CLE) requires a specific diagnostic approach to identify subtypes, to address differential diagnostic considerations, and to rule out systemic organ involvement. In addition to a detailed patient's history and clinical evaluation of the skin, histopathologic and immunofluorescent examination of a skin biopsy as well as laboratory screening are recommended. Photoprovocation tests can be performed to confirm the diagnosis of CLE and to assess photosensitivity in these patients. Recently, a scoring system for the activity of the cutaneous manifestations in CLE has been developed and validated which involves anatomical areas and morphologic signs of the skin lesions. In all subtypes of CLE, antimalarials are still the treatment of choice. Advances in biotechnology have led to the development of several novel agents for the treatment of autoimmune diseases; however, controlled trials have not been performed in patients with CLE. Furthermore, there is need for specific immunointervention, especially for patients who fail to respond to standard therapies. The second part of this review will enable the reader to differentiate CLE from other diseases and to suggest specific diagnostic procedures and treatment approaches.
Hautklinik, Heinrich-Heine-Universität Düsseldorf. kuhnan@uni-duesseldorf.de
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Kuhn
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Gensch
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Ständer
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Bonsmann
D000962:Antimalarials / Q000009:adverse effects / Q000627:therapeutic use; D001323:Autoantibodies / Q000097:blood; D001706:Biopsy; D003937:Diagnosis, Differential; D005938:Glucocorticoids / Q000009:adverse effects / Q000627:therapeutic use; D006801:Humans; D007166:Immunosuppressive Agents / Q000009:adverse effects / Q000627:therapeutic use; D008178:Lupus Erythematosus, Cutaneous / Q000175:diagnosis* / Q000188:drug therapy / Q000473:pathology; D008856:Microscopy, Fluorescence; D012867:Skin / Q000473:pathology; D014466:Ultraviolet Rays
D000962:Antimalarials; D001323:Autoantibodies; D005938:Glucocorticoids; D007166:Immunosuppressive Agents