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
