Cutaneous Lupus Erythematosus: A Comprehensive Review

The 2001 document provides an extensive review of cutaneous lupus erythematosus (LE), including its classification into LE-nonspecific and LE-specific skin disorders, with the latter being divided into acute cutaneous LE (ACLE), subacute cutaneous LE (SCLE), and chronic cutaneous LE (CCLE) which includes discoid LE (DLE). It highlights the importance of skin biopsies for diagnosis, the role of genetic and environmental factors such as UV light, and the association of ACLE with active systemic lupus erythematosus (SLE). The document also covers the challenges in differential diagnosis due to overlapping features with other skin diseases and the utility of laboratory tests like antinuclear antibody (ANA) tests. Treatment strategies discussed include sun protection, local and intralesional corticosteroids, and systemic agents like antimalarials, with hydroxychloroquine sulfate being the most common in the U.S. The document notes the necessity of ophthalmologic evaluations due to the risk of retinal damage from antimalarials and mentions other treatments such as dapsone, synthetic retinoids, clofazimine, thalidomide, and gold treatments, while systemic corticosteroids and immunosuppressive agents are considered last-resort options due to toxicity. Smoking is mentioned to reduce the efficacy of antimalarials, and anecdotal treatments like interferon, phototherapy, and vitamin E are briefly discussed, though their effectiveness is not well established. The document does not specify the number of people studied as it is a review, not a study.