Systemic Lupus Erythematosus: A Systematic Approach to Arthritis of Rheumatic Diseases: Volume 4

Syuichi Koarada

• Publisher: Bentham Science Publishers
• Year: 2022
• ISBN:
  9789815050653
• Topic: Medicine
• Subtopic: Rheumatology, Orthopedics & Prosthetics

Systemic lupus erythematosus (SLE) is an autoimmune disease. SLE affects many parts of the body, with joint pain in the knees and hands being commonly reported symptoms. Arthritis is, therefore, one of the most common symptoms of the disease. This book comprehensively summarizes information about SLE for medical professionals and students. The volume illustrates the process of making accurate diagnoses through systematic interpretation of ABCDEGFGI parameters: A (Alignment): malalignment and deformation; B (Bone): bone changes; C (Capsular lesions): cartilage and intra-articular lesions; D (Distribution): four dimensional distributions; E (Extra-bone): extra-articular soft tissue; F (Further information): further additional medical information; G (Goal): general analysis and integrated comprehensive diagnosis; H (Heal and Heath): treatment and prognosis; and I (Immunological analysis): immunological interpretations. Key Features: - Presents information about the clinical features of SLE and differential diagnosis through 11 chapters - Covers both rheumatic symptoms and systemic symptoms - Provides a comprehensive approach to SLE diagnosis and management which blends both rheumatology and radiology - Explains the ABCDEFGI system for diagnosing and treating SLE patients - Includes more than 750 detailed figures illustrating important information - Includes references for further reading The book is an informative resource for a wide range of scholarly and professional readers who may encounter SLE patients in clinical settings: rheumatologists, orthopedists, radiologists, physiatrists, immunologists, pediatricians, general physicians, medical technicians, caregivers and specialists in internal medicine.

Skin Manifestations in Patients with Systemic Lupus Erythematosus

Syuichi Koarada^{1, 2, 3, *}, Tetsuhiro Maesaki²

¹ Department of Medical Technology and Sciences, International University of Health and Welfare, Okawa, Japan

² Division of Rheumatology, Takagi Hospital, Okawa, Japan

³ Division of Rheumatology, Faculty of Medicine, Saga University, Saga, Japan

Abstract

Skin manifestations are one of the most common presenting symptoms in systemic lupus erythematosus (SLE). Skin lesions are seen in more than 80% of patients with SLE at some point during the disease and are also the initial manifestations. The skin manifestations of SLE are varied. Skin lesions of SLE include lupus malar rash, maculopapular lupus rashes, palmar erythemas, bullous rashes, subacute cutaneous lupus erythematosus, chilblain lupus and discoid rashes. These skin lesions can be classified as acute, subacute, and chronic lesions. Specific skin lesions are important for the diagnosis of SLE. This review will outline and illustrate the skin lesions of SLE.

Keywords: Chilblain lupus, Discoid rashes, Maculopapular rashes, Malar rash, Palmar erythema, Subacute cutaneous erythematosus, Systemic lupus erythematosus (SLE).

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^* Corresponding author Syuichi Koarada: Department of Medical Technology and Sciences, International University of Health and Welfare, Okawa, Japan; Email: [email protected]

1. INTRODUCTION

Skin symptoms are one of the most common manifestations of systemic lupus erythematosus (SLE). Various lesions of the skin and mucous membranes are often found in more than 80% of SLE patients at some point during the disease. The symptoms of the skin in SLE are diverse [1]. Importantly, cutaneous symptoms are the first signs of SLE in up to 25% of cases [1].

The American College of Rheumatology (ACR)-SLE classification criteria and the Systemic Lupus International Collaborating Clinics (SLICC) classification criteria include mucocutaneous signs and are used for the SLE classification.

SLE is associated with a wide range of oral mucosal lesions, including cheilitis, erythematous patches, “honeycomb” plaques, discoid lesions, lichen planus-like lesions, and discrete ulcers.

In 1979, Sontheimer et al. classified cutaneous lesions of LE based on their morphologic features and duration [2]. They classified the lesions into three types: the chronic type, which is typical of discoid lupus erythematosus (DLE); the acute type, which is fixed and scarring lupus erythematosus (LE) and in severe SLE; and recurrent, superficial, non-scarring LE was classified as subacute cutaneous lupus erythematosus (SCLE). SCALE is classified into papulo-squamous type and annular-polycyclic type.

Specific skin lesions of SLE are classified...