In addition, the mechanism of action can also involve both immunological and nonimmunological pathways. True drug-induced psoriasis tends to occur in a de-novo fashion in patients with no family or previous history of psoriasis. In a case-controlled and case-crossover study of 110 patients who were hospitalized for extensive psoriasis vulgaris, beta blockers were considered a major factor in triggering or aggravating psoriasis. 4 Clinicians may be faced with a difficult decision in patients with simultaneous collagen vascular disease, such as progressive discoid or subacute cutaneous lupus erythematosus and psoriasis. Keywords: Cutaneous lupus erythematosus, Acute cutaneous lupus erythematosus, Subacute cutaneous lupus erythematosus, Chronic cutaneous lupus erythematosus, Discoid lupus erythematosus, lupus erythematosus profundus, Chilblain cutaneous lupus erythematosus, Lupus erythematosus tumidus, Systemic lupus erythematosus, Treatment, Diagnosis. As with SLE, Subacute Cutaneous Lupus Erythematosus (SCLE) occurs primarily in young to middle aged women 11. Discoid lesions are very distinct in appearance from other entities, however the early indurated erythematous plaques of DLE can resemble those of psoriasis, lymphocytoma cutis, cutaneuous T-cell lymphomoa, granuloma faciale, polymorphous light eruption eruption, and sarcoidosis 32. Lupus erythematosus is a name given to a collection of autoimmune diseases in which the human immune system becomes hyperactive and attacks normal, healthy tissues. The most common and severe form is systemic lupus erythematosus. There have been several cases where a single gene influence appears to be present, but this is rare. In addition to medicative therapy, due to the psychological and social impacts that Lupus may have on an individual, Cognitive Behavioural Therapy (CBT) has also been demonstrated to be effective in reducing stress, anxiety, and depression in lupus sufferers 11.
Why are there skin problems that occur in rheumatoid patients? Rheumatic diseases such as rheumatoid arthritis, lupus, dermatomyositis, and scleroderma are thought to be autoimmune diseases. In addition, the amount of rheumatoid factor in the blood can be an indication of the state of activity of the immunological illness inside the body. Patients with this form of skin lupus have a somewhat higher risk for developing the more severe internal complications of systemic lupus erythematosus compared to another common form of lupus skin disease named discoid lupus erythematosus. It normally occurs by itself and not in conjunction with any other symptoms or illnesses, and generally speaking, the cause of most cases of morphea is still unknown. This paper covers the SLE-specific cutaneous changes: malar rash, discoid rash, photosensitivity, and oral mucosal lesions as well as SLE nonspecific skin manifestations, their pathophysiology, and management. In addition, serum autoantibodies are considered immunologic markers for distinct clinical types of the illness. The Cutaneous Lupus Erythematosus Disease Area and Severity Index (CLASI) is used as a clinical tool that standardizes the way disease activity is described and provides guidelines for identifying a clinical change. Serious systemic disease is rare, but when it occurs, patients may develop life-altering sequelae.
There are two main forms of localized scleroderma: morphea and linear scleroderma. Severe cases may also cause open sores or damage to the skin and bones, if the circulation is cut off for too long. Many of these same genes are linked to related diseases, such as rheumatoid arthritis and systemic lupus erythematosus. Systemic lupus erythematosus, or SLE, is the most common form of lupus. Like other autoimmune diseases, lupus occurs when your body’s immune system malfunctions, attacking your tissues and organs. There’s no cure for lupus, but treatments can reduce the severity of symptoms and enhance your quality of life. More than 16,000 new cases of lupus are reported each year in the United States. See additional information. SLE is an autoimmune disease that causes a chronic inflammatory condition. In addition, women who have a history of, or who are at high risk for, blood clots (particularly women with antiphospholipid syndrome) should not use OCs. Symptoms are the same in both cases: fever, chest pain, labored breathing, and coughing. A very serious and rare condition called pulmonary hypertension occurs when high pressure develops as a result of damage to the blood vessels of the lungs.
Rheumatic Skin Disease: Frequently Asked Questions
Systemic lupus erythematosus (SLE) is a chronic inflammatory disease of unknown cause that can affect virtually any organ of the body. In addition, SLE occurs more commonly in certain racial and ethnic groups. Among the patients diagnosed later with the SLICC criteria, in the majority of cases the delay was due to the combination of malar rash and photosensitivity into the acute cutaneous SLE criterion. As a loose guide, we diagnose SLE in patients who have two or three of the ACR or SLICC criteria, along with at least one other feature that may be associated with, but is not specific for, SLE. The lesions start as erythematous or violaceous papules or vesicles. Lichen simplex chronicus often occurs on the lower legs, the neck, the scalp, or the scrotum. Usually mild ones are adequate but, in severe disease, stronger steroid applications may be required and, in very severe cases, oral steroids can be needed. Treatment of severe, ongoing, active disease requires corticosteroids, often hydroxychloroquine, and sometimes immunosuppressants. In addition to its needed effects, some unwanted effects may be caused by chloroquine. One was a Hispanic patient who developed vitiligo-like skin depigmentation after 1 month of chloroquine therapy for cutaneous lupus erythematosus. At least 2 cases of exacerbation of psoriasis requiring hospitalization have been reported. SCLE is a subtype of cutaneous lupus erythematosus (CLE); other subtypes include acute cutaneous lupus erythematosus and chronic cutaneous lupus erythematosus. Lynch WS, Roenigk HH Jr: Lupus erythematosus and psoriasis vulgaris. Discoid and Systemic Lupus Erythematosus and Their Variants, ed 2.
Many people with autoimmune hepatitis experience remission within two years of starting treatment. In severe cases, they are multiple blisters, called bullae. Dermatological (skin) manifestations may occur and include psoriasis, acne, and pustules on the palms of the hands and soles of the feet. SLE can affect almost any organ or system in the body including blood vessels, muscles, joints, the digestive tract, lungs, kidneys, heart and central nervous system. It is an autoimmune disease, just like diabetes type 1, psoriasis, thyroiditis and rheumatoid arthritis. 2. Is lupus truly a woman’s disease and if so why? Some men do have lupus, me for one, but I wonder if it’s because men don’t go to the doctor as often as women and have less of a chance to be diagnosed correctly. In adults, about nine of every 10 cases of lupus occur in women. SLE may occur with other autoimmune conditions (e.g., thyroiditis, hemolytic anemia, idiopathic thrombocytopenia purpura). The skin, liver, and blood problems resolve by 6 months, but the most serious sign congenital heart block requires a pacemaker and has a mortality rate of about 20. Two additional plaques, treated with SA alone or untreated, served as controls. The inflammatory skin diseases treated with PDL consisted of: psoriasis, acne vulgaris, lupus erythematodes, granuloma faciale, sarcoidosis, eczematous lesions, papulopustular rosacea, lichen sclerosis, granuloma annulare, Jessner lymphocytic infiltration of the skin, and reticular erythematous mucinosis.
The most common connective tissue diseases include systemic lupus erythematosus, antiphospholipid syndrome, ankylosing spondylitis, psoriatic arthritis, rheumatoid arthritis, and systemic sclerosis, all of which will be discussed in this chapter. In some patients, intracardiac thrombi or pulmonary hypertension may occur. In some cases, leaflet involvement is less severe but the disease process affects the annulus, resulting in valvular regurgitation. Few cases of psoriasis/SLE have been published in the literature.