Other rare cutaneous lupus variants

Question 1

Bullous SLE occurs predominantly in what population?

Answer 1

African Americans

Question 2

What is the pathogenesis of bullous SLE?

Answer 2

• Antibodies against NC1 and NC2 of type VII collagen (same as EBA!)

Question 3

What must be present to make diagnosis of bullous SLE?

Answer 3

patient must meet criteria for SLE

Question 4

how does bullous SLE present?

Answer 4

tense subepidermal blisters on background of urticarial to erythematous base

Question 5

histopath of bullous SLE:

Answer 5

• subepidermal bulla with neutrophils at DEJ and in dermal papillae

Question 6

DIF of bullous SLE:

Answer 6

• continuous granular to linear deposition of IgG, IgM, IgA and or C3 along BMZ

Question 7

Salt-split-skin of bullous SLE:

Answer 7

• dermal reactivity

Question 8

What is treatment of bullous SLE?

Answer 8

Dapsone (rapid response in 1-2 days)

• this does not treat the systemic symptoms

Question 9

Treating a patient with Dapsone who you suspect has bullous SLE or EBA and they respond well within 1-2 days, which disease do they have?

Answer 9

bullous SLE

Question 10

Targetoid lesions clinically resembling EM arising in setting of cutaneous lupus is called:

Answer 10

Rowell’s syndrome

Question 11

cutaneous lupus patient gets way too much sun and skin starts peeling off, what is this called?

Answer 11

TEN-like lupus erythematosus