Discoid cutaneous lupus erythematosus vca animal hospital. It is classified as either localised, affecting skin above the neck only, or generalised, affecting above and below the neck. Discoid or cutaneous skin lupus erythematosus systemic lupus erythematosus sle druginduced erythematosus neonatal lupus. They develop as an inflamed growth with scaling and a warty like appearance. Discoid lupus erythematosus dle is a chronic photosensitive skin eruption which can be either localised or widespread. Cutaneous lupus erythematosus clinical and laboratory. Discoid lupus erythematosus dle is a form of chronic cutaneous lupus erythematosus characterized by hyperkeratotic inflammatory plaques which eventuate into. However, the exact etiology of discoid lupus erythematosus dle is not well understood. Discoid lupus erythematosus british association of. Discoid rash erythematosus raised patches with adherent. Discoid lupus erythematosus american osteopathic college. Discoid lupus erythematosus chronic lesions skin site. It often begins as an erythematous papule or plaque with scale fig.
Discoid lupus erythematosus dle is a disease in which coinshaped discoid red bumps appear on the skin. Discoid lupus erythematosus causes currently, the cause of why dle is being experienced by some is still unknown or idiopathic in nature. Discoid lupus erythematosus dle is a disfiguring autoimmune skin disease and the most common form of chronic cutaneous lupus erythematosus. Immunoglobulins are found in the skin in this autoimmune disease. Aug 21, 2018 cutaneous lupus erythematosus cle can be divided into 3 main subtypes. The relationship between discoid and systemic lupus. It has a characteristic clinical appearance consisting of red, scaly plaques with resulting pigmentary changes and scars. Pathology outlines lupus erythematosus panniculitis. Aug 21, 2018 lupus erythematosus is a polygenic autoimmune disease linked to various hla subtypes, immune signaling, and environmental factors, which ultimately leads to autoantibody production and tcell dysfunction.
The typical presentation of dle is wellcircumscribed, indurated, sometimes scaly round or oval plaques with pigmentary change, often red to purple in color. Pdf cutaneous manifestations of systemic lupus erythematosus. The sores are usually located on the face, ears and scalp. 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. You can help by taking up membership for more information contact. Cutaneous manifestations of systemic lupus erythematosus. Discoid lupus erythematosus dle is one of several rashes that can occur in lupus. Discoid lupus erythematosus pictures, treatment, symptoms.
Discoid lupus erythematosus dle, a chronic dermatological disease, is the most common form of chronic cle. Understanding discoid or cutaneous lupus erythematosus. Discoid lupus erythematosus dle is an uncommon autoimmune disease of the basal cell layer of the skin. A number of candidate genes have been identified which increase the risk of developing cle. On the other hand, many sle patients may present symptoms of discoid disease. Aug 10, 2015 the pathophysiology of cutaneous lupus erythematosus cle encompasses the complex interactions between genetics, the environment, and cells and their products. It typically causes a loss of color in the hairless, moist part of the nose. Only about 10% of all patients with dle will go on to develop the multiorgan disease sle. Lupus erythematosus le comprises an uncommon group of connective tissue disorders. Lupus erythematosus may be of several types including discoid dle and systemic sle. Affected horses develop areas of patchy erythema, crusting alopecia, and scaling on the face, ears, and neck.
About 5%10% of patients with discoid lupus erythematosus will progress to systemic lupus. Lupus erythematosus profundus is the preferred terminology for lesions of lupus erythematosus panniculitis that have overlying changes of discoid lupus, namely vacuolar interface dermatitis, basement membrane thickening, scale, follicular plugging and both perifollicular and periadnexal inflammation. Ethnic differences in the clinical expression of systemic lupus erythematosus. The most common initial symptom is scaling and loss of pigment on the nose. The center areas may appear lighter in color surrounded by an area darker than the normal skin. The term discoid refers to a rash of distinct reddened patches covered with grayish brown scales that may appear on the face, neck, and scalp. Acute cutaneous lupus erythematosus acle most commonly presents as symmetric erythema overlying the malar cheeks and nasal bridge with sparing of the nasolabial folds butterfly rash. Severe chronic blepharitis and scarring ectropion associated with discoid lupus erythematosus. Lupus uk is the national charity caring for those with systemic lupus erythematosus sle and discoid lupus erythematosus dle, supporting people as they develop the symptoms prior to diagnosis and those already diagnosed. Discoid lupus erythematosus can be categorized into localized, generalized, and childhood dle 1. Discoid lesions are the most common skin manifestations of ccle.
The skin is one of the target organs most variably affected by the disease. Discoid lupus erythematosus definition discoid lupus erythematosus dle is a disease in which coinshaped discoid red bumps appear on the skin. Laporan kasus cutaneus discoid lupus erythematosus. Z, and the scale may thicken and become adherent fig.
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. Lupus is a general term that refers to any of the various chronic inflammatory diseases that are marked by inflammation of the skin and are caused by autoimmunity. Clinically, the lesions appear as diskshaped plaques surmounted by a white adherent scale that also involves the hair follicles. It was first described in dogs by griffin and colleagues in 1979. Discoid lupus erythematosus investigations bmj best. Dle most commonly occurs on the head and is characterized by welldefined inflammatory plaques that evolve into atrophic, disfiguring scars. The main types of lupus are discoid lupus erythematosus dle, subacute cutaneous lupus erythematosus scle and systemic lupus erythematosus. A number of candidate genes have been identified which increase the risk. The lesion of discoid lupus erythematosus is usually clinically characteristic.
It is confined to the skin and does not cause any systemic symptoms. In this case, no laboratory or other known systemic abnor mality was evident on clinical examination other than. It occurs in humans and cats, more frequently occurring in dogs. Lupus erythematosus is a chronic inflammatory autoimmune disease with a wide range of clinical manifestations ranging from an indolent chronic cutaneous form to a severe potentially lifethreatening disease, systemic lupus erythematosus discoid lupus erythematosus is a subphenotype of chronic cutaneous lupus erythematosus, characterised by scaly diskshaped. Ccle encompasses discoid lupus erythematosus dle, lupus erythematosus tumidus le tumidus. Previous research on cutaneous lupus erythematosus lesions has been directed at examining the relationship between the scarring lesions of discoid lupus erythematosus dle and systemic lupus erythematosus sle and the pathogenesis of the lesions of cutaneous lupus erythematosus. Discoid lupus erythematosus dle is a chronic skin condition that develops circular inflamed red patches with a scaling and crusty appearance, ranging from 510 mm in diameter. Eventually, the color deepens and the plaques become edematous with elevation fig. 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. Pathology of discoid lupus erythematosus dr sampurna roy md. Cutaneous lupus erythematosus cle is the second most common presenting symptom of autoimmune lupus erythematosus le.
Cutaneous lupus erythematosus cutaneous le includes three subsets of lespecific skin diseases. The third feature may be discoid rash sensitivity 18%. Description the disease called discoid lupus erythematosus only affects the skin, although similar discoid skin lesions can occur in the serious disease called systemic lupus erythematosus sle. The american college of rheumatology acr established 11 criteria as a classificatory instrument to operationalise the definition of sle in clinical trials. Discoid rash raised erythematous patches with keratotic scaling, follicular plugging, and atrophic scarring 3. Discoid lupus erythematosus cutaneous lupus erythematosus. Lupus erythematosus is a polygenic autoimmune disease linked to various hla subtypes, immune signaling, and environmental factors, which ultimately leads to autoantibody production and tcell dysfunction. Other articles where discoid lupus erythematosus is discussed. The cause of lupus is unknown, and the disease usually takes one of two forms. Canine discoid lupus erythematosus showing loss of noseprint, depigmentation, ulceration and tissue destruction all characteristic of the syndrome. 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.
Lupus erythematosus le is a chronic, autoimmune disease that includes a broad spectrum of symptoms. The lupus erythematosus is described as having two distinct forms. Dle lesions begin as welldemarcated erythematous macules or papules with a scaly surface, and frequently evolve into larger coinshaped plaques. Discoid lupus erythematosus dle is a chronic inflammatory condition of the skin. Lesions in the oral cavity may be present in each of these two types of lupus erythematosus. The surface of the nose becomes smooth gray, and ulcerated, instead. Discoid lupus erythematosus dle is a relatively common form of chronic cutaneous lupus, although its presentation in children is rare. Discoid or cutaneous lupus refers to symptoms affecting the skin. Discoid lupus erythematosus at the vermilion border of the. At one end of the range is systemic lupus erythematosus, which can. Dle can cause permanent scarring if treatment is inadequate. 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. Chronic cutaneous lupus erythematosus chronic cutaneous lupus erythematosus ccle is more common in women, affecting from 1. Lesions may be part of systemic lupus or may represent discoid lupus without organ involvement, which is a separate diagnostic entity.
The aim of this chapter, which is set out as below, is to highlight the key features of these conditions. Recent data have provided enhanced understanding of these interactions and the mechanism by which they cause disease. Cutaneous lupus erythematosus cle can be divided into 3 main subtypes. The pathophysiology of cutaneous lupus erythematosus cle encompasses the complex interactions between genetics, the environment, and cells and their products. Discoid lupus affects only the skin and does not usually involve internal organs. It presents with red, inflamed, coinshaped patches of skin with a scaling and crusty appearance, most often on the scalp, cheeks, and ears. Discoid lupus erythematosus definition of discoid lupus. Most common form of chronic cutaneous lupus erythematosus.
Discoid lupus erythematosus symptoms, diagnosis and. The term lupus erythematosus is applied to a range of related disorders. Discoid lupus erythematosus an overview sciencedirect topics. Pathophysiology of cutaneous lupus erythematosus arthritis. Discoid lupus erythematosus dle is the most common form of cutaneous lupus erythematosus. Sunscreens, protective clothing and protective makeup including wig are helpful in preventing damage to the skin. Classic lupus is also termed systemic lupus erythematosus and typically initially appears as a rash accompanied by joint pain and fever.
The skin around the nose may also look abnormal, and rarely, the. Lupus erythematosus primary care dermatology society uk. Chronic cutaneous lupus erythematosus discoid lupus erythematosus dle. Determining risk factors for developing systemic lupus erythematosus in patients with discoid lupus erythematosus. The only known information about dle is that it is an autoimmune kind of disorder, i. This is found in up to 90 percent of affected dogs.
May 11, 2017 discoid lupus erythematosus dle is a form of chronic cutaneous lupus erythematosus characterized by hyperkeratotic inflammatory plaques which eventuate into areas of scarring. 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. Dle discoid lupus collie nose what is discoid lupus. Discoid lupus erythematosus dle is the most common chronic form of cutaneous lupus. Cutaneus discoid lupus erythematosus cdle merupakan penyakit autoimun sistemik dengan penyebab multifaktor, yang ditandai keterlibatan beberapa organ dan sistem oleh karena kelainan imunologi. Aug 30, 2017 discoid lupus discoid lupus erythematosus is a chronic autoimmune disease affecting the skin. Lupus erythematosus le is a group of diverse, persistent inflammatory autoimmune diseases and often affects the skin. Discoid lupus erythematosus dle is a chronic autoimmune skin condition characterized by erythematous lesions with scaly and crusty appearances. Lesions are welldemarcated erythematous macules or papules with a scaly surface, which frequently evolve into larger coinshaped plaques. Disease severity is wide ranging, with most suffering milder. 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. Systemic lupus erythematosus sle is a multiorgan autoimmune disease of unknown etiology with many clinical manifestations. The discoloration can be accompanied by ulcers and bleeding. Lupus erythematosus induced by medications, ultraviolet radiation, and other exogenous agents.
Lupus is the latin word for wolf and has been used to name various skin diseases at least since the 10 th century. 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 an uncommon skin rash, usually made worse by exposure to sunlight. Lesions precede the onset of systemic symptoms in 25 percent of patients, many of whom present to dermatologists for their initial evaluation. Discoid lupus erythematosus dle and subacute cutaneous lupus erythematosus scle are variants of cutaneous lupus that may occur independently or as manifestations of systemic lupus erythematosus. Risk of systemic lupus erythematosus is approximately 5%. These lesions develop as a red, inflamed patch with a scaling and crusty appearance. The center areas may appear lighter in color with a rim darker than the normal skin. Discoid lupus erythematosus, also known as chronic cutaneous le, consists of cutaneous lesions, usually without evidence of systemic manifestations. Discoid lupus discoid lupus erythematosus is a chronic autoimmune disease affecting the skin.
Le is included among the so called connective tissue diseases and is divided into one systemic form sle and one cutaneous. Manifestasi klinis cdle bervariasi dan melibatkan banyak organ baik beberapa organ berbeda maupun berkaitan selama periode penyakit berlangsung. Discoid lupus erythematosus dle is the most common form of chronic cutaneous lupus erythematosus. Classic dle lesions begin as redpurple macules, papules or small plaques and rapidly develop a. Feb 22, 2016 discoid lupus erythematosus dle is a chronic photosensitive skin eruption which can be either localised or widespread. It gets its name from the coinshaped lesions it produces. Dle generally represents the benign pole of the le spectrum. The lesions are typically chronic scaly plaques on the face, scalp and ears. The relationship between discoid and systemic lupus erythematosus.
Discoid lupus erythematosus dle is a skin condition of dogs. Discoid lupus erythematosus investigations bmj best practice. 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 lupus erythematosus is a chronic skin condition characterized by inflammation and scarring type skin lesions which occur on the face, ears, scalp and at times on other body areas.
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