Monday, November 4, 2013

ACUTE COETANEOUS LUPUS ERYTHEMATOSUS


ACUTE COETANEOUS LUPUS ERYTHEMATOSUS
         ACLE  :
Localized
         characterized by confluent symmetric erythematic and edema centered over the malar eminences The nasolabial folds are typically spared. (malar rash ).
         The forehead and V-area of the neck can be similarly involved.
         Generalized
      ( photosensitive lupus dermatitis” )
  • ACLE begins on the face as small, discrete macular, or papular lesions, or both, that later become confluent and hyperkeratosis
  • Generalized ACLE, a less common variety, presents as a more widespread morbilliform or exanthemata eruption
  • ACLE that can stimulate toxic epidermal necrolysis
  • strong association between ACLE and systemic LE activity,

         ACLE  :photosensitive , transient, lasting only several days or weeks.
         Post inflammatory pigmentary change is most prominent in patients with LE with darkly pigmented skin
         ACLE lesions do not result in scarring.
         Superficial ulceration of the oral or nasal mucosa is a frequent accompaniment of ACLE
         The posterior areas of the hard palate are most commonly affected, however, the labial, gingival, buccal, and lingual mucosa may also be involved. In the early stages of such lesions,
         the pathology is usually nonspecific;


SUBACUTE CUTANEOUS LUPUS ERYTHEMATOSUS
         SCLE skin lesions including
         symmetric erythema centrifugum,
         disseminated DLE,
          autoimmune annular erythema,
         subacute disseminated in LE,
         superficial disseminated LE,
         psoriasiform LE, pityriasiform LE, and
         maculopapular photosensitive LE

         SCLE consists of non scarring papulosquamous or annular skin lesions
         LE-specific histopathology and occur in a characteristic photo-distribution
         a higher frequency of anti-Ro (SS-a) antibody positivity
         SCLE lesions :
          sun-exposed areas : upper back, shoulders, extensor aspects of the arms, V-area of the neck, and less commonly, on the face
         Infrequently, SCLE lesions present initially with any appearance of erythema multiforme
         Lesions typically heal without scarring


Friday, November 1, 2013

SYSTEMIC LUPUS ERYTHEMATOUS part 3


SYSTEMIC LUPUS ERYTHEMATOUS part 3

Manifestations Musculoskeletal System
• arthralgia, arthritis
• Myalgia, Myositis
• Tenosynovitis → Jaccoud Arthritis
• Osteonecrosis

SLE: Jacoud's arthropathy

SLE can cause skin problems ......

Manifesatasi Mucocutaneous System
• A common manifestation
• Classic symptoms shaped malar rash
• Overview clinic diverse
• Grouped :
   - Acute lupus Kurataneus:
• very fotosensitive,
• take several / day weeks,
• improved when the cause hyperpigmentation spots

Sub Acute Cutaneous Lupus
• There are two forms of
   1. papulosqumosa
   2.ruam annular erythema / eritrema sentrifugum / psoriasis
Distribubusinya on areas that are exposed to sunlight fotosensitive
• Linked Ro antibodies
• Typically central area of hyperpigmentation
• If recovery does not cause scarring