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Zeitschrift für Rheumatologie

, Volume 72, Issue 5, pp 429–435 | Cite as

Kutaner Lupus erythematodes und Hautveränderungen beim systemischen Lupus erythematodes

  • M. SticherlingEmail author
Leitthema

Zusammenfassung

Hautmanifestationen finden sich beim Lupus erythematodes (LE) häufig und in vielfältiger Weise. Es lassen sich unspezifische und spezifische Symptome unterscheiden, wobei Letztere dem akut kutanen LE, dem subakut kutanen LE, dem chronisch kutanen und dem intermittierenden LE zuzuordnen sind und in unterschiedlichem Zusammenhang zu einem systemischen LE stehen. Anamnestische und klinische Untersuchungen, klinisch-chemische, immunserologische sowie je nach verdächtigtem Organbefall apparative Untersuchungen belegen die Krankheitsaktivität und bestimmen Zeitpunkt und Ausmaß einer Therapie. Neben Einstellen von Zigarettenrauchen und Alkoholgenuss sowie konsequentem UV-Schutz ist dabei eine topische Therapie mit Glukokortikosteroiden, ggf. Calcineurininhibitoren bei umschriebenen Formen möglich. Vielfach wird jedoch eine systemische Therapie, allen voran mit Antimalariamitteln als Basistherapie erforderlich sein. Verschiedene Immunsuppressiva sind je nach Krankheitsaktivität, ggf. in Kombination mit systemischen Kortikosteroiden Alternativen. Wichtig ist eine frühzeitige und effektive Therapie, um eine irreversible Vernarbung der Haut oder eine innere Organschädigung zu vermeiden.

Schlüsselwörter

Hautmanifestationen Antimalariamittel Topische Therapie Diagnostik Systemische Therapie 

Cutaneous lupus erythematosus and skin manifestations in systemic lupus erythematosus

Abstract

Skin manifestations are frequently observed in lupus erythematosus (LE) and are manifold. Nonspecific and specific symptoms can be differentiated with the latter belonging to the dermatologically well-characterized clinical entities of acute cutaneous, subacute cutaneous, chronic cutaneous as well as intermittent cutaneous LE. These forms are differentially related to systemic LE. Patient history and clinical examinations, laboratory and immunoserological findings as well as organ imaging results determine the time point as well as the intensity of therapy. Apart from cessation of smoking and alcohol consumption as well as stringent UV protection, topical therapy with corticosteroids or calcineurin inhibitors may suffice with limited forms of the disease. In many cases, however, systemic treatment with antimalarial drugs as a basic treatment is mandatory. Several immunosuppressive agents can alternatively be used in conjunction with systemic corticosteroids. Early and effective therapy is important to prevent irreversible scarring of the skin and to avoid internal organ damage.

Keywords

Skin manifestations Antimalarials Topical therapy Diagnostics Systemic therapy 

Notes

Interessenkonflikt

Der korrespondierende Autor weist auf folgende Beziehungen hin: Forschungsunterstützung Actelion, Biogen, Pfizer; Advisory-Board-Mitglied Abbott/Abbvie, Pfizer, MSD, Leo; Vortragender für Abbott/Abbvie, Pfizer, MSD, Leo, Janssen.

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Copyright information

© Springer-Verlag Berlin Heidelberg 2013

Authors and Affiliations

  1. 1.HautklinikUniversitätsklinikum ErlangenErlangenDeutschland

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