Systemic lupus erythematosus, the most common form of lupus, is a chronic autoimmune disease that can cause severe fatigue and joint pain. Discoid lupus erythematosus in dogs dr robert hilton bvschons macvsc canine medicine cert. Discoid lupus only affects the skin, causing rashes. Discoid lupus erythematosus is an uncommon skin rash, usually made worse by exposure to sunlight. In fact, a 2016 study demonstrated that over one third of patients with cutaneous lupus met criteria for depression or anxiety with need for psychiatric intervention. Pdf systemic lupus erythematosus discoid in dog canis. Discoid lupus erythematosus is the most common form of chronic cutaneous erythematosus and can occur as localized form 80% with lesions on the face, ears, and scalp or as disseminated discoid lupus erythematosus 20% with lesions above and below the neck 2. He also used the term lupus erythematosus and published the fi rst illustrations in his atlas of skin diseases in 1856. Racial disparities in mortality associated with systemic. These lesions develop as a red, inflamed patch with, scaling and a crusty appearance. Although the agents triggering idiopathic lupus remain incompletely defined and the mechanisms involved are unclear, druginduced lupus dil provides an opportunity to study defined. It has a prolonged course and can have a considerable effect on quality of life. This type of lupus can occur on any part of the body, but usually appears where the skin is exposed to sunlight. The skin around the nose may also look abnormal, and rarely, the.
Discoid lupus erythematosus following herpes zoster. Lupus sle causes, symptoms, treatment versus arthritis. Druginduced lupus is similar to sle, but occurs as. Norman r 2016 the history of lupus erythematosus and discoid lupus. Lupus erythematosus le is a chronic multiorgan autoimmune disease with a spectrum of clinical and serological presentations. Systemic lupus erythematosus larissa lisnevskaia, grainne murphy, david isenberg systemic lupus erythematosus is a remarkable and challenging disorder. The term discoid refers to a rash of distinct reddened patches covered with grayish brown scales that may.
Systemic lupus erythematosus is an autoimmune disease that affects many systems, including the skin, musculoskel etal, renal, neuropsychiatric, hematologic, cardiovascular, pulmonary, and. Early recognition and treatment improves the prognosis. Balance the severity of cutaneous lupus against the risks of therapy. While the face, trunk and extremities are frequently affected, eyelid involvement is uncommon and often presents as a diagnostic problem.
Lupus flares when genetically predisposed people encounter drugs or environmental agents that trigger the disease. Dle is a scarring autoimmune disease that can linger on for a prolonged period, not surprisingly, the psychological impact is considerable. 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 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. Its diversity of clinical features is matched by the complexity of the factors genetic, hormonal, and environmental that cause it, and the array of autoantibodies with which it is associated. Cutaneous discoid lupus areas showing depigmentation and erythema should be selected for biopsy, rather than areas of ulceration andor crusts. Discoid rash raised erythematous patches with keratotic scaling, follicular plugging, and atrophic scarring 3. Discoid lupus erythematosus dle is a chronic inflammatory condition of the skin. At one end of the range is systemic lupus erythematosus, which can. Discoid lupus erythematosus of the eyelids uveitis. Lespecific skin manifestations can be further subdivided into acute cle acle, subacute cle scle and chronic cle ccle where classic discoid le dle.
Clinically, the lesions appear as diskshaped plaques surmounted by a. Chronic cutaneous lupus erythematosus discoid lupus erythematosus dle. Pdf discoid lupus erythematosus dle is the most common form of chronic cutaneous lupus erythematosus. Discoid lupus affects only the skin and does not usually involve internal organs. Discoid lupus erythematosus dle is one of several rashes that can occur in lupus. Dle lesions begin as welldemarcated erythematous macules or papules with a scaly surface, and frequently evolve into larger coinshaped plaques. Lupus erythematosus le is a chronic, autoimmune disease that includes a broad spectrum of symptoms. Discoid lupus erythematosus is known to negatively impact patient quality of life. It presents with red, inflamed, coinshaped patches of skin with a scaling and crusty appearance, most often on the scalp, cheeks, and ears. Symptoms of these diseases can affect many different body systems, including joints, skin, kidneys, blood cells, heart, and lungs. Discoid lupus erythematosus clinics in dermatology. Discoid lupus erythematosus symptoms, diagnosis and treatment. Discoid lupus discoid lupus erythematosus is a chronic autoimmune disease affecting the skin. Lupus is the latin word for wolf and has been used to name various skin diseases at least since the 10 th century.
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. Our objective was to update the eular recommendations for the management of systemic lupus erythematosus sle, based on emerging new evidence. On the other hand, many sle patients may present symptoms of discoid disease. Discoid lupus erythematosus is a rare skin disease in horses that is believed to be a variant of systemic lupus erythematosus. Discoid lupus erythematosus an overview sciencedirect. Discoid lupus erythematosus is the most common type of chronic cutaneous lupus ccle, an autoimmune skin condition on the lupus erythematosus spectrum of illnesses. Cerebral venous thrombosis in systemic lupus erythematosus. The center areas may appear lighter in color with a rim. It is more common in african americans and people of american indian and asian descent than in. Recurrent outbreaks of inflammatory lesions usually affecting photo exposed areas face, ears and scalp, lead to a prominent scarring that might have a high impact on the quality of life of the patients. Jul 31, 2018 discoid lupus erythematosus is confined to the skin and is not associated with symptoms from other organs. Aug 15, 2016 systemic lupus erythematosus, the most common form of lupus, is a chronic autoimmune disease that can cause severe fatigue and joint pain. Early diagnosis and treatment of discoid lupus erythematosus. It gets its name from the coinshaped lesions it produces.
Lesions are welldemarcated erythematous macules or papules with a scaly surface, which frequently evolve into larger coinshaped plaques. Lupus erythematosus is an autoimmune disorder that often affects the scalp and causes alopecia. The primary lesion is an erythematous papule or plaque with slighttomoderate scale see the images below. Although cutaneous lupus can cause many types of rashes and lesions sores, the most commoncalled discoid rashis raised, scaly and red, but not itchy. Discoid lupus erythematosus an overview sciencedirect topics. In this disease, the immune system of the body mistakenly attacks healthy tissue. Although dle usually responds to topical or intralesional corticosteroids andor oral antimalarials, some dle is resistant to. Discoid lupus erythematosus causes, signs, symptoms. Each person is different and the location of the rash, as well as the appearance, may differ. The word discoid is a reference to the disk shapes of the individual lesions that comprise the rash. It can affect the joints, skin, brain, lungs, kidneys, and blood vessels. However, approximately 10 percent of people who have discoid lupus may develop sle systemic lupus erythematosus.
It can affect the skin, joints, kidneys, brain, and other. Pdf to determine the demographic data, clinical pattern and therapeutic outcome in patients with discoid lupus erythematosus dle. Importance discoid lupus erythematosus dle is a chronic variant of cutaneous lupus erythematosus, an autoimmune inflammatory disorder of the skin. The manhattan lupus surveillance program mlsp is a populationbased retrospective registry of cases with sle and related diseases including pdle in manhattan and was used to provide estimates of the prevalence and incidence of pdle across. Lupus erythematosus an overview sciencedirect topics. Discoid lupus erythematosus dle lesions frequently are characteristic. Sle is an autoimmune disease in which the immune system attacks its own tissues, causing widespread inflammation and tissue damage in the affected organs. Dle can cause permanent scarring if treatment is inadequate. Discoid lupus symptoms can be either sporadic or constant. Cerebral venous thrombosis in systemic lupus erythematosus marie vidailhet, md, jeancharles piette, md, bertrand wechsler, md, mariegermaine bousser, md, and pascal brunei, md we describe six cases of cerebral venous thrombosis in patients with systemic lupus erythematosus. Dle discoid lupus collie nose what is discoid lupus. Objective epidemiological data for primary discoid lupus erythematosus pdle remain limited, particularly for racialethnic populations in the usa. Discoid lupus erythematosus dle is consistently reported as the most common subtype, and this may be because as a chronic disorder, it is. The diagnosis is usually made by clinical examination.
Discoid lupus erythematosus dle is a chronic photosensitive skin eruption which can be either localised or widespread. Research by the national resource center on lupus estimates that at least 1. Richardson, in dubois lupus erythematosus and related syndromes ninth edition, 2019. Discoid lupus erythematosus, which mainly affects the skin. This form of lupus is typically limited to the skin.
Chronic cutaneous le most commonly is manifest by the discoid. The isomorphic response is the appearance of new lesions from a preexisting skin condition at a site of trauma. Acute cutaneous lupus including malar rash, photosensitive lupus rash or subacute cutaneous lupus 2. Sle or patchy and scarring discoid lupus erythematosus. Discoid lupus erythematosus dle is the most common chronic form of cutaneous lupus. Systemic lupus erythematosus sle is an autoimmune disease. Discoid lupus erythematosus dle is a benign, autoimmune disorder of the skin.
Dle generally represents the benign pole of the le spectrum. Lesions are often localized to the scalp and can result in permanent scarring, disfiguration, and irreversible alopecia. Discoid lupus erythematous dle is the most common type of chronic cutaneous lupus erythematosus with a small risk of. Lupus information sheet continued lupus strikes mostly women of childbearing age 1544. Clinical criteria acute cutaneous lupus or subacute cutaneous lupus. Discoid lupus erythematosus differentials bmj best. Early effective treatment may lead to total clearing of skin lesions, but failure of. Ldle, characterized by well defined macular or papular erythematous lesions with firm scales adher. Lupus was fi rst recognised as a systemic disease with visceral manifestations by moriz kaposi 18371902. Discoid or cutaneous lupus refers to symptoms affecting the skin.
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. Cumulative mortality of prevalent systemic lupus erythematosus sle cases diagnosed in 2002, by blackwhite race georgia lupus registry, 20022016 cumulative mortality for prevalent sle cases was calculated using kaplanmeier survival analysis to indicate the probability of sle patients dying at a specified time since 2002. It is characterised by persistent scaly, disklike plaques on scalp, face and ears that may cause pigmentary changes, scarring and hair loss. Discoid lupus erythematosus is confined to the skin and is not associated with symptoms from other organs. An atrophic porcelainwhite plaque on the vertex with areas of erythema, scale. Affected horses develop areas of patchy erythema, crusting alopecia, and scaling on the face, ears, and neck. Systemic lupus erythematosus sle, is the most common type of lupus. Discoid lupus erythematosus dle is the most disfiguring form of cutaneous lupus erythematous cle. A more severe form is called systemic lupus erythematosus sle, which can affect internal organs. Three main types of lupus are recognized discoid, druginduced, and systemic. Discoid lupus erythematosus symptoms, diagnosis and. 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.
Treatment in sle aims at remission or low disease activity and prevention of flares. It typically causes a loss of color in the hairless, moist part of the nose. Discoid lesions are the most common skin manifestations of ccle. We report the case of a 20yearold woman with a history of systemic lupus erythematosus sle and dle who developed a painful, multidermatomal, vesicular rash. An atrophic porcelainwhite plaque on the vertex with areas of erythema, scale, dyspigmentation on the periphery. Hebra was also the first to publish illustrations of lupus.
Immunoglobulins are found in the skin in this autoimmune disease. Most common form of chronic cutaneous lupus erythematosus. However, men, children, and teenagers develop lupus, too. Discoid lupus erythematosus in saudi arabia longdom. Discoid lupus erythematosus of the eyelids harvey siy uy, md introduction. Systemic lupus erythematosus lupus is a chronic longlasting autoimmune disease that can affect many parts of the body. Current insights into the management of discoid lupus. Discoid lupus erythematosus in the nigerians jacyk. The commonest form of ccle is localized discoid lupus erythematosus ldle, characterized by welldefined macular or papular erythematous lesions with firm. The most common and most severe form is systemic lupus erythematosus. People can get it in one small area on the skin, or it can be widespread. Ppleuritis or l e ur it c p a nob vd f s c pericarditis onf irm edby ecg, uv cp al s 7. The four different types of lupus lupus foundation of america. The term lupus erythematosus is applied to a range of.
Treatment of alopecia in chronic cutaneous lupus erythematosus. Understanding discoid or cutaneous lupus erythematosus. Loss of follicular ostia, areas of follicular plugging, dyspigmentation and pinpoint follicular red dots. 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. Discoid plaques of lupus erythematosus may also appear markedly devoid of pigmentation, just as in vitiligo, but atrophy is usually evident. Populationbased prevalence and incidence estimates of. Lupus erythematosus may be of several types including discoid dle and systemic sle. The term lupus erythematosus is applied to a range of related disorders. Aug 21, 2018 discoid lupus erythematosus is known to negatively impact patient quality of life.
The four different types of lupus lupus foundation of. Discoid lupus erythematosus dle is a skin condition of dogs. Discoid lupus causes, symptoms and treatment patient. Cutaneous lupus erythematosus cle is lupus affecting the skin in this autoimmune disease, the bodys immune system attacks healthy skin. Sle can affect many parts of the body in several ways.
Microsoft powerpoint discoid lupus erythematosus in dogs. The discoloration can be accompanied by ulcers and bleeding. Which physical findings are characteristic of discoid. Lupus erythematosus le is a group of diverse, persistent inflammatory autoimmune diseases and often affects the skin. Cutaneous lupus skin lupus is lupus that affects the skin in the form of a rash or lesions. Discoid lupus erythematosus british association of dermatologists. Hair loss may be diffuse and nonscarring systemic lupus erythematosus. Women of color are 23 times more likely to develop lupus. Discoid lupus erythematosus is a chronic dermatological disease that can lead to scarring, hair loss, and hyperpigmentation changes in skin if it. Aug 30, 2017 discoid lupus discoid lupus erythematosus is a chronic autoimmune disease affecting the skin. People of all races and ethnic groups can develop lupus. Lupus erythematosus is a collection of autoimmune diseases in which the human immune system becomes hyperactive and attacks healthy tissues. Hiv infection can present with skin rash and leukopenia and thus must be ruled out in all such cases. Discoid lupus can cause permanent scarring if it is not treated or if treatment is not effective.
Discoid cutaneous lupus erythematosus vca animal hospital. Pdf on may 1, 2017, natalia nunes costa and others published systemic lupus erythematosus discoid in dog canis familiaris. Druginduced lupus is similar to sle, but occurs as the result of an overreaction to certain medications. The disseminated form of discoid lupus erythematosus, especially when involving the.
It is confined to the skin and does not cause any systemic symptoms. Apr 21, 2020 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. Sunscreens, protective clothing and protective makeup including wig. Patients with chronic discoid lupus erythematosus constituted 046% of all out. The rash may last for days or years, and can recur. Th e systemic form was further established by osler in baltimore and jadassohn in vienna. Lupus erythematosus, also called lupus, an autoimmune disorder that causes chronic inflammation in various parts of the body. Feb 22, 2016 discoid lupus erythematosus dle is a chronic photosensitive skin eruption which can be either localised or widespread. A general discussion of lupus erythematosus is found in chapters 9 and 14. The symptoms of this form of lupus include a rash on the face, scalp, or elsewhere. Ldle, characterized by welldefined macular or papular erythematous lesions with firm scales adher. Discoid lupus erythematosus dle may develop on traumatized skin and also may arise at sites of a prior cutaneous eruption. Alopecias in lupus erythematosus pubmed central pmc. The most common immune mediated skin disease in australia there are gross differences in how the canine and human discoid lupus appears.