Lupus eruthematosus Flashcards
(26 cards)
Manif of DLE/
In young adults and women.
dull red macules to plaques atrophy dcarring and oigment changes.
Histo lupus:
epidermis demonstrate effacement of rete ridges pattern or irregular acanthoses. compract hyperkeratosis without parakeratosis. follicular plugginh.
Elev cd3 and cd34 favor LP or DLE
LP
a chronic unremitting form of Zle Affecting fingertiks, rims of ears, calves and heels spec women. usually oreceded by DLE on face.
Chilblain LE (Hutchinson)
is a
Rear but distinctive entity. Patient present with edematous erythematous plaques usually on trunk.
histo: Patchy superficial depp perivascular and periasnexal lymphoid infiltrate that affects eccrine coil. Dermal mucin typical
Tumid Lupus erythematosus
Tx for Tumid LE
Anti malaria
LE panniculitis
Age gender
20-45
female
LE panniculitis manif
decelop subc nodules firm sharply defined and non tender. proximal extremities are typically involved.
Histo: Lymphoid nodules in subcutaenous septa, necrosis of fat lobule, fibrinoid or hyaline degeneration of lipocytes. dermal mucin. dermal collagen hyalinization.
SCLE gender age
White women
15-40
SCLE MANIF
scaly and evolve as polycyclic annular lesuons or psoriasiform plaquesz vary from red tonpibk w faint violet tones. scale is thin and easily detached. tenglangiectasia and dyspigmentation.
occur usually on sun exposed areas.
others
3/4 arthralgia or arthritis.
20% leukopenia
80% ANA test positive.
majority of cases have antibodies to Ro/SSA antigen.
+ for HLA DR3.
La/SSB may also be oresent and many pxs gave overlap feat w sjogren syndrome
medication induced SCLE us traditionally most often related to what deug
Hydroxychlorothiazide
SCLE positive w what HLA
HLA DR3
Ro/ssa
La/ssb may also be present
SCLE histo
VID- K
Vacuoular interface dermatitis
Mild hyperkeratosis
parakeratosis
manif if dec C4.
Hyperkeratosis palms and soles
Neonatal lupus erythematosis are in girls born to mothers who carry what antibodyz
Ro/SSA antibody.
no skin lesions at birth. dev on 1st weeks of life.
Neonatal lupus erythematosus manif
Annular erythematous macules and plaques mY appear on hand and extremities. periocilar involvement (racoon eyes) May be prominent.
resolv spont 6 months of age. health without scarring.
Hao many months of close monitoring
first three months then by 9 mos of life most cases resolve w only 10% of infants w persistent antibodies at that time.
risk that second child will have neonatal LE- approx 25%
sle
on book
Localized DLE loc where
Discoud lesions usually above neck part on sun exposed siyes like scalp bridge of nose malar sreas lower lip and ears.
hypertrophic LE lesions
Non pruritic papulonodular lesions on arms and handsresembling keratoacanthoma or hypertrophic LP.
dermoscopy dist scc and hypertrophic le
lesions fround in LE not in LP
Bmz thickening
dermal mucin
eccrine coil involvement
subcutaneous nodular lymphoid infiltrates.
LE - LP overlap syndrome
Lesions are large, atrophic, hypopigemnted red or pink plaques pigment abn become prominent over time and fine telangiectasias and scaling are usually present. extensor aspects of extremities and midline back are affected. prominent palmoplantar involvement. Nail dystrophy anonychia scarring alopecia and oral involvement.
response to tx: poor.
top steroid dapsone thalidomide isotret- may be effective.
MMF
histo lupus erythematosus panniculitis ( profundus)
lymphoid nodues in subcu septa
necrosis of fat lobule and fibrinoid or hyaline degeneration of remaining lipocytes.
