Lupus and DM Flashcards
(30 cards)
discoid LE aka…
chronic cutaneous LE
describe discoid lesions
indurated erythematous thin papules with adherent scale and follicular plugging
what is the “capet tack” sign
follicular plugs with removal of scale
what do discoid lesions leave behind?
atrophy, telangectasias, dyschromia, scarring SCC can develop in scars
describe classic histology of DLE
atropic epidermis with follicular plugging
vacuolar degeneration of basal layer
perivascular with periadnexal lymphocytic infiltrate
inc mucin
% DLE that progresses to SLE
5-10%
treatment of DLE
sun avoidance
topical or IL steorids
antimalarials
topical calcineurin inhibitors
C2 deficiency a/w…
increase susceptibility to autoimmune conditions, esp lupus
pathophys of neonatal lupus
transplacental passage of anti-Ro/SSA abs (less commonly anti-La/SSB
Ab a/w higher mortality rate in neonatal lupus
anti-U1-RNP
when does neonatal lupus present and when does it resolve
presents in first few months of life and resovles spontaneously within 6 months w/o scarring
neonatal lupus is a/w
heart block
thrombocytopenia
transaminitis
describe SCLE lesions
papulosquamous or annular/polycyclinc erythematous scaly patches/plaques on shoulders, trunk, extensor arms (spares face typicallY)
Abs a/w SCLE
60-80% + ANA
60-90% + anti-Ro
what % will eventually meet SLE criteria
50%
HLA associated with SCLE
B8»_space; DR3»_space; DRw2, DQ1
drugs that can cause drug induced SCLE
HCTZ terbinafine, griseofulvin diltiazem ACEi NSAIDs INF/TNFa PUVA
drugs that cause SLE
hydralazine procainamide chlorpromazine INH quinidine practolol D-penicilliamine PUVA minocycline
Diagnostic criteria for SLE
4 off 11 criteria MD SOAP BRAIN - Malar rash - Discoid rash - Serositis - Oral ulcers - Arthritis - Photosensitivity - Blood (heme) - Renal - ANA - Immuno abnormality - Neurologic
multiple dermatofibromas a/w
SLE
Abs that are highly specific for SLE
anti-dsDNA, anti-Sm
HLA associations with SLE
DR2, DR3
timing of skin lesions in DM with muscle weakness
skin lesions 2-3 months before muscle weakness
grotton’s papules vs grotton’s sign
papules = violaceous papules over MP joints sign = red scaling over knuckles, knees, elbows
