Lupus erythematosus & Chronic Graft-Versus-Host-Disease

Question 1

What variants of LP lesions can Chronic graft-versus-host-disease lesions present as?

Answer 1

Reticular, Erosive or Ulcerative

Question 2

What are the clinical features of Chronic graft-versus-host-disease?

Answer 2

Can be asymptomatic
Can cause burning oral discomfort
Oral dryness
Reduced opening

Question 3

Describe the skin lesions of discoid lupus erythematosus

Answer 3

Scaly atrophic plaques on sun-exposed skin (sun protection is vital)
Presenting as one or more oval plaques

Question 4

What are the diffrent types of lupus erythematosus?

Answer 4

Systemic LE
Discoid LE

Question 5

How do you manage oral and skin lesions of discoid lupus erythematosus?

Answer 5

Oral - Same managment of LP
Skin - Suncream (SPF 50) & Chloroquine & potent steroids

Question 6

What is the aetiology of discoid lupus erythematosus?

Answer 6

Autoimmune disorder
May be precipitated by drugs, environmental, hormonal or viral factors

Question 7

What are the risk factors of Chronic graft-versus-host-disease?

Answer 7

• Poorly matched grafts
• Older donors or recipients

Question 8

What is lupus erythematosus?

Answer 8

Chronic cutaneous & oral disorder (painless)

Characterised by scaly skin patches in sun-exposed areas & LP-like oral lesions

Question 9

What is the managment of Chronic graft-versus-host-disease?

Answer 9

Topical analgesic – Lidocaine
Corticosteroids – Betamethasone mouthwash or clobetasol gel
Tacrolimus ointment
Regular monitoring (as inc malignancy risk)

Question 10

What is the aetiology of Chronic graft-versus-host-disease?

Answer 10

Immunological reaction of graft lymphocytes against recipient host cells following allogeneic bone marrow transplant

Question 11

Where in the mouth can you find discoid lupus erythematosus lesions?

Answer 11

Bilateral on labial, buccal or alveolar mucosa or vermillion border

BUT also palate lesions present (which is rare in LP)