Cutaneous Lesions in Systemic Lupus Erythematosus

The document from 1989 provides an overview of the cutaneous manifestations of Systemic Lupus Erythematosus (SLE), noting that skin involvement occurs in 75 to 88 percent of patients and is a key factor in diagnosis. It reports that cutaneous lesions are the first sign of SLE in 25 percent of patients and are crucial for diagnosis, as they make up 4 of the 11 American Rheumatism Association criteria. The document references a study by Hochberg et al. that defined the frequency of lesions in 150 SLE patients between 1980 and 1984. It highlights the strong link between sunlight exposure and SLE, with over 50 percent of patients developing a photoeruption, and discusses the role of ultraviolet light and autoantigens like the Ro antigen in inducing lesions. The document categorizes lesions into those present at initial presentation and those observed during the disease course, including the butterfly rash, photosensitive lupus dermatitis, and bullous LE. It concludes that the relationship between skin disease activity and systemic disease is inconsistent. Additionally, it describes various specific lesions such as bullous SLE, subacute cutaneous LE, discoid LE, and nonspecific lesions like alopecia, mucous membrane lesions, and vascular lesions, emphasizing their diagnostic and prognostic importance. Lupus panniculitis and other conditions like Sjögren's syndrome associated with SLE are also mentioned, as well as cutaneous lesions resulting from SLE therapy.