Cutaneous Manifestations of Lupus Erythematosus

Abstract

Lupus erythematosus (LE) is a chronic inflammatory autoimmune disease characterized by diverse clinical features and autoantibodies. Lupus erythematosus includes both systemic disease (SLE), which may affect multiple organ systems, and cutaneous disease (CLE) involving the skin and mucous membranes. Cutaneous disease has been estimated to occur as the initial manifestation in 25 % of patients diagnosed with systemic lupus erythematosus and in 70–80 % of patients at some point during their disease course.

The skin manifestations of LE are generally classified as either LE specific or LE nonspecific. The diagnosis of the subtype of CLE is based on the patient’s history, clinical findings, skin biopsy histology, and laboratory results. Treatment of CLE is multifaceted and includes photoprotection, topical therapies, and systemic medications. Antimalarials are first-line systemic therapy for CLE. Additional systemic therapies include antimetabolite immunosuppressants, thalidomide, dapsone, retinoids, intravenous immunoglobulin, and biologics. The increasing standardization of CLE assessment will potentially lead to more rigorous clinical trials investigating potential therapies for cutaneous lupus.