Lupus Erythematosus: Cutaneous Manifestations and Treatment

Detalhes bibliográficos
Autor(a) principal: Alves, Francisca
Data de Publicação: 2019
Outros Autores: Gonçalo, Margarida
Tipo de documento: Artigo
Idioma: eng
Título da fonte: Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos)
Texto Completo: https://doi.org/10.29021/spdv.77.3.1118
Resumo: Cutaneous lupus erythematosus (CLE) includes a broad range of dermatologic manifestations, which may or may not be associated with systemic manifestations. Specific CLE - defined by the presence of an interface dermatitis on histopathological evaluation - is divided into several sub-types, namely acute CLE (ACLE), subacute CLE (SCLE) and chronic CLE (CCLE). CCLE includes discoid lupus erythematosus (DLE), as well as other rarer forms such as LE profundus (LEP). Nonspecific skin findings, such as livedo reticularis or purpura are more frequently seen in patients with systemic disease. Diagnosis requires classification of the subtype, through a combination of physical examination, laboratory studies, histology and sometimes direct immunofluorescence, at the same time ensuring to exclude systemic disease. Regarding the treatment of CLE, antimalarials and topical steroids continue to be the standard of care; however, immunosuppressants, thalidomide analogs and monoclonal antibodies are possible systemic therapies for recalcitrant disease. Patient education on proper sun protection and avoidance of triggers is crucial. This paper reviews the clinical manifestations of CLE, as well as the treatment.
id RCAP_105b912c11655103d16369d3a85c9767
oai_identifier_str oai:ojs.revista.spdv.com.pt:article/1118
network_acronym_str RCAP
network_name_str Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos)
repository_id_str 7160
spelling Lupus Erythematosus: Cutaneous Manifestations and TreatmentLúpus Eritematoso: Manifestações Cutâneas e TratamentoLupus Erythematosus, Cutaneous/complicationsLupus Erythematosus, Cutaneous/diagnosisLupus Erythematosus, Cutaneous/therapyLúpus Eritematoso Cutâneo/complicaçõesLúpus Eritematoso Cutâneo/diagnósticoLúpus Eritematoso Cutâneo/tratamentoCutaneous lupus erythematosus (CLE) includes a broad range of dermatologic manifestations, which may or may not be associated with systemic manifestations. Specific CLE - defined by the presence of an interface dermatitis on histopathological evaluation - is divided into several sub-types, namely acute CLE (ACLE), subacute CLE (SCLE) and chronic CLE (CCLE). CCLE includes discoid lupus erythematosus (DLE), as well as other rarer forms such as LE profundus (LEP). Nonspecific skin findings, such as livedo reticularis or purpura are more frequently seen in patients with systemic disease. Diagnosis requires classification of the subtype, through a combination of physical examination, laboratory studies, histology and sometimes direct immunofluorescence, at the same time ensuring to exclude systemic disease. Regarding the treatment of CLE, antimalarials and topical steroids continue to be the standard of care; however, immunosuppressants, thalidomide analogs and monoclonal antibodies are possible systemic therapies for recalcitrant disease. Patient education on proper sun protection and avoidance of triggers is crucial. This paper reviews the clinical manifestations of CLE, as well as the treatment.Lúpus eritematoso cutâneo engloba um vasto leque de manifestações dermatológicas, que podem ou não acompanhar- se de acometimento sistémico. As lesões cutâneas específicas – definidas histologicamente pela presença de dermatite de interface – são ainda dividas em subtipos, concretamente lúpus agudo, subagudo ou crónico. O subtipo crónico inclui ainda o lúpus discóide, bem como variantes mais raras, como o lúpus profundo. As manifestações cutâneas não específicas, nomeadamente o livedo reticular ou purpura, são mais frequentes nos doentes com acometimento sistémico. A abordagem diagnóstica implica a correcta subclassificação do subtipo, através duma combinação de exame físico, estudo laboratorial, análise histológica e ocasionalmente imunofluorescência directa, sendo imperativo a exclusão de atingimento sistémico. Do ponto de vista terapêutico, os corticosteróides tópicos e antimaláricos permanecem como a base da terapêutica; no entanto, imunossupressores, análogos da talidomida e anticorpos monoclonais são terapias sistémicas disponíveis para o tratamento da doença recalcitrante. A educação do doente acerca de medidas de fotoproteção e evicção de factores despoletantes é fulcral.Sociedade Portuguesa de Dermatologia e Venereologia2019-10-10T00:00:00Zinfo:eu-repo/semantics/articleinfo:eu-repo/semantics/otherinfo:eu-repo/semantics/publishedVersionapplication/pdfhttps://doi.org/10.29021/spdv.77.3.1118oai:ojs.revista.spdv.com.pt:article/1118Journal of the Portuguese Society of Dermatology and Venereology; Vol 77 No 3 (2019): July / September; 201-214Revista da Sociedade Portuguesa de Dermatologia e Venereologia; v. 77 n. 3 (2019): Julho / Setembro; 201-2142182-24092182-2395reponame:Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos)instname:Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informaçãoinstacron:RCAAPenghttps://revista.spdv.com.pt/index.php/spdv/article/view/1118https://doi.org/10.29021/spdv.77.3.1118https://revista.spdv.com.pt/index.php/spdv/article/view/1118/786Alves, FranciscaGonçalo, Margaridainfo:eu-repo/semantics/openAccess2022-10-06T12:35:12Zoai:ojs.revista.spdv.com.pt:article/1118Portal AgregadorONGhttps://www.rcaap.pt/oai/openaireopendoar:71602024-03-19T16:11:11.212927Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) - Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informaçãofalse
dc.title.none.fl_str_mv Lupus Erythematosus: Cutaneous Manifestations and Treatment
Lúpus Eritematoso: Manifestações Cutâneas e Tratamento
title Lupus Erythematosus: Cutaneous Manifestations and Treatment
spellingShingle Lupus Erythematosus: Cutaneous Manifestations and Treatment
Alves, Francisca
Lupus Erythematosus, Cutaneous/complications
Lupus Erythematosus, Cutaneous/diagnosis
Lupus Erythematosus, Cutaneous/therapy
Lúpus Eritematoso Cutâneo/complicações
Lúpus Eritematoso Cutâneo/diagnóstico
Lúpus Eritematoso Cutâneo/tratamento
title_short Lupus Erythematosus: Cutaneous Manifestations and Treatment
title_full Lupus Erythematosus: Cutaneous Manifestations and Treatment
title_fullStr Lupus Erythematosus: Cutaneous Manifestations and Treatment
title_full_unstemmed Lupus Erythematosus: Cutaneous Manifestations and Treatment
title_sort Lupus Erythematosus: Cutaneous Manifestations and Treatment
author Alves, Francisca
author_facet Alves, Francisca
Gonçalo, Margarida
author_role author
author2 Gonçalo, Margarida
author2_role author
dc.contributor.author.fl_str_mv Alves, Francisca
Gonçalo, Margarida
dc.subject.por.fl_str_mv Lupus Erythematosus, Cutaneous/complications
Lupus Erythematosus, Cutaneous/diagnosis
Lupus Erythematosus, Cutaneous/therapy
Lúpus Eritematoso Cutâneo/complicações
Lúpus Eritematoso Cutâneo/diagnóstico
Lúpus Eritematoso Cutâneo/tratamento
topic Lupus Erythematosus, Cutaneous/complications
Lupus Erythematosus, Cutaneous/diagnosis
Lupus Erythematosus, Cutaneous/therapy
Lúpus Eritematoso Cutâneo/complicações
Lúpus Eritematoso Cutâneo/diagnóstico
Lúpus Eritematoso Cutâneo/tratamento
description Cutaneous lupus erythematosus (CLE) includes a broad range of dermatologic manifestations, which may or may not be associated with systemic manifestations. Specific CLE - defined by the presence of an interface dermatitis on histopathological evaluation - is divided into several sub-types, namely acute CLE (ACLE), subacute CLE (SCLE) and chronic CLE (CCLE). CCLE includes discoid lupus erythematosus (DLE), as well as other rarer forms such as LE profundus (LEP). Nonspecific skin findings, such as livedo reticularis or purpura are more frequently seen in patients with systemic disease. Diagnosis requires classification of the subtype, through a combination of physical examination, laboratory studies, histology and sometimes direct immunofluorescence, at the same time ensuring to exclude systemic disease. Regarding the treatment of CLE, antimalarials and topical steroids continue to be the standard of care; however, immunosuppressants, thalidomide analogs and monoclonal antibodies are possible systemic therapies for recalcitrant disease. Patient education on proper sun protection and avoidance of triggers is crucial. This paper reviews the clinical manifestations of CLE, as well as the treatment.
publishDate 2019
dc.date.none.fl_str_mv 2019-10-10T00:00:00Z
dc.type.driver.fl_str_mv info:eu-repo/semantics/article
info:eu-repo/semantics/other
dc.type.status.fl_str_mv info:eu-repo/semantics/publishedVersion
format article
status_str publishedVersion
dc.identifier.uri.fl_str_mv https://doi.org/10.29021/spdv.77.3.1118
oai:ojs.revista.spdv.com.pt:article/1118
url https://doi.org/10.29021/spdv.77.3.1118
identifier_str_mv oai:ojs.revista.spdv.com.pt:article/1118
dc.language.iso.fl_str_mv eng
language eng
dc.relation.none.fl_str_mv https://revista.spdv.com.pt/index.php/spdv/article/view/1118
https://doi.org/10.29021/spdv.77.3.1118
https://revista.spdv.com.pt/index.php/spdv/article/view/1118/786
dc.rights.driver.fl_str_mv info:eu-repo/semantics/openAccess
eu_rights_str_mv openAccess
dc.format.none.fl_str_mv application/pdf
dc.publisher.none.fl_str_mv Sociedade Portuguesa de Dermatologia e Venereologia
publisher.none.fl_str_mv Sociedade Portuguesa de Dermatologia e Venereologia
dc.source.none.fl_str_mv Journal of the Portuguese Society of Dermatology and Venereology; Vol 77 No 3 (2019): July / September; 201-214
Revista da Sociedade Portuguesa de Dermatologia e Venereologia; v. 77 n. 3 (2019): Julho / Setembro; 201-214
2182-2409
2182-2395
reponame:Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos)
instname:Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informação
instacron:RCAAP
instname_str Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informação
instacron_str RCAAP
institution RCAAP
reponame_str Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos)
collection Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos)
repository.name.fl_str_mv Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) - Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informação
repository.mail.fl_str_mv
_version_ 1799130567592116224