​Dermatology - Systemic Lupus Erythematosus (SLE)

​Dermatology - Systemic lupus erythematosus (SLE)
Systemic lupus erythematosus is a severe autoimmune illness that affects multiple systems in the body, including the connective tissue and blood vessels. The prevalence of this condition is ninefold higher in women compared to men, and it is more prevalent among individuals of African heritage. The onset often occurs in the third or fourth decade of life, and triggering factors include a family history of the condition and exposure to ultraviolet (UV) radiation.

Arthralgia or arthritis, abdominal pain, and CNS symptoms are accompanied by fatigue, fever, weight loss, and malaise.
Abnormalities
The lesions last for a duration ranging from weeks (acute) to months (chronic) and are characterized by itchiness or a burning sensation. During the subacute and acute stages of the disease, a rash resembling a butterfly shape appears on the cheeks of the face. This rash is red, continuous, and clearly defined, with thin layers of skin peeling off, occasional open sores, and dried secretions. During the subacute phase, there are well-defined psoriasiform papulosquamous lesions in areas exposed to light. These lesions have a slight delicate scaling and develop into bright red confluent plaques that are oval, arciform, or polycyclic, similar to those seen in psoriasis. Additionally, there are annular, bright red lesions with central regression and minimal scaling. Both conditions may exhibit telangiectasia, although there is an absence of follicular clogging and minimal induration. The lesions disappear with little tissue shrinkage (without scarring) and reduced pigmentation. During the chronic phase, the lesions first appear as brilliant red papules that gradually develop into strongly defined plaques. These plaques are covered with scales that are firmly attached and have spines on the undersurface, like carpet tacks when observed under a magnifying lens. Plaques exhibit a circular or oval shape, and can be annular or polycyclic, with uneven edges. They grow outward from the edges and shrink inward from the center, leading to tissue atrophy and scarring. Lesions that have been "burned out" can appear as pink or white macules and scars. However, they may also be hyperpigmented, particularly in individuals with brown or black skin.
Medical assessment and determination of a person's health condition.
The diagnosis is established by evaluating clinical symptoms, histology, lupus band test, and serology according to the revised criteria set by the American Rheumatism Association (ARA).


Standard precautions include relaxation and refraining from direct sunlight exposure. Administer prednisone at a dosage of 60 mg per day, divided into multiple doses. Additionally, consider using immunosuppressants if there are indications of central nervous system or renal involvement, hemolytic crises, thrombocytopenia, or severe sickness. Hydroxychloroquine is effective in treating skin lesions in subacute and chronic systemic lupus erythematosus (SLE), but it does not decrease the requirement for prednisone.
Adhere to safety measures when using hydroxychloroquine. Other options encompass chloroquine or quinacrine.