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Fitzpatrick Tables > Chapter 61 - Lupus Erythematosus > Flashcards

Chapter 61 - Lupus Erythematosus Flashcards

1
Q

TABLE 61-2
The 1982 Revised Criteria for Classification of Systemic Lupus Erythematosus

Fixed erythema, flat or raised, over the malar eminences, tending to spare the nasolabial folds

A

Malar rash

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2
Q

TABLE 61-2
The 1982 Revised Criteria for Classification of Systemic Lupus Erythematosus

Erythematous raised patches with adherent keratotic scaling and follicular plugging; atrophic scarring may occur in older lesions

A

Discoid rash

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3
Q

TABLE 61-2
The 1982 Revised Criteria for Classification of Systemic Lupus Erythematosus

Skin rash as a result of unusual reaction to sunlight, by patient history or physician observation

A

Photosensitivity

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4
Q

TABLE 61-2
The 1982 Revised Criteria for Classification of Systemic Lupus Erythematosus

Oral or nasopharyngeal ulceration, usually painless, observed by a physician

A

Oral ulcers

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5
Q

TABLE 61-2
The 1982 Revised Criteria for Classification of Systemic Lupus Erythematosus

Nonerosive arthritis involving 2 or more peripheral joints, characterized by tenderness, swelling, or effusion

A

Arthritis

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6
Q

TABLE 61-2
The 1982 Revised Criteria for Classification of Systemic Lupus Erythematosus

Serositis (2)

A

Pleuritis
Pericarditis

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7
Q

TABLE 61-2
The 1982 Revised Criteria for Classification of Systemic Lupus Erythematosus

Convincing history of pleuritic pain or rub heard by a physician or evidence of pleural effusion

A

Pleuritis

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8
Q

TABLE 61-2
The 1982 Revised Criteria for Classification of Systemic Lupus Erythematosus

Documented by electrocardiogram or rub or evidence of pericardial effusion

A

Pericarditis

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9
Q

TABLE 61-2
The 1982 Revised Criteria for Classification of Systemic Lupus Erythematosus

Renal disorder (2)

A

Persistent proteinuria
Cellular casts

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10
Q

TABLE 61-2
The 1982 Revised Criteria for Classification of Systemic Lupus Erythematosus

Persistent proteinuria— ___ g/day or greater than ___ if quantitation not performed

A

Persistent proteinuria— >0.5 g/day or greater than 3+ if quantitation not performed

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11
Q

TABLE 61-2
The 1982 Revised Criteria for Classification of Systemic Lupus Erythematosus

May be red cell, hemoglobin, granular, tubular, or mixed

A

Cellular casts

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12
Q

TABLE 61-2
The 1982 Revised Criteria for Classification of Systemic Lupus Erythematosus

Neurologic disorder (2)

A

Seizures
Psychosis

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13
Q

TABLE 61-2
The 1982 Revised Criteria for Classification of Systemic Lupus Erythematosus

Hematologic disorder (4)

A

Hemolytic anemia
Leukopenia
Lymphopenia
Thrombocytopenia

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14
Q

TABLE 61-2
The 1982 Revised Criteria for Classification of Systemic Lupus Erythematosus

Hemolytic anemia—with __________

A

Hemolytic anemia—with reticulocytosis

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15
Q

TABLE 61-2
The 1982 Revised Criteria for Classification of Systemic Lupus Erythematosus

Leukopenia— _____ μL total on ___ or more occasions

A

Leukopenia— <4000 μL total on 2 or more occasions

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16
Q

TABLE 61-2
The 1982 Revised Criteria for Classification of Systemic Lupus Erythematosus

Lymphopenia— _____/μL on ___ or more occasions

A

Lymphopenia— <1500/μL on 2 or more occasions

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17
Q

TABLE 61-2
The 1982 Revised Criteria for Classification of Systemic Lupus Erythematosus

Thrombocytopenia— _____ μL in the absence of offending drugs

A

Thrombocytopenia— <100,000 μL in the absence of offending drugs

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18
Q

TABLE 61-2
The 1982 Revised Criteria for Classification of Systemic Lupus Erythematosus

Immunologic disorder (3)

A

Anti-DNA
Anti–Smith antigen
Positive finding of antiphospholipid antibodies

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19
Q

TABLE 61-2
The 1982 Revised Criteria for Classification of Systemic Lupus Erythematosus

Positive finding of antiphospholipid antibodies based on

(1) an abnormal serum level of __________,

(2) a _____ test result for _____ using a standard method, or

(3) a _____ serologic test for _____ known to be _____ for at least _____ and confirmed by __________ or fluorescent treponemal antibody absorption test __________

A

Positive finding of antiphospholipid antibodies based on

(1) an abnormal serum level of immunoglobulin G or immunoglobulin M anticardiolipin antibodies,

(2) a positive test result for lupus anticoagulant using a standard method, or

(3) a false-positive serologic test for syphilis known to be positive for at least 6 months and confirmed by Treponema pallidum immobilization or fluorescent treponemal antibody absorption test

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20
Q

TABLE 61-2
The 1982 Revised Criteria for Classification of Systemic Lupus Erythematosus

An abnormal titer of __________ by immunofluorescence of an equivalent assay at any point in time and in the absence of drugs known to be associated with “drug-induced lupus” syndrome

A

An abnormal titer of antinuclear antibody by immunofluorescence of an equivalent assay at any point in time and in the absence of drugs known to be associated with “drug-induced lupus” syndrome

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21
Q

TABLE 61-6
Therapeutic Options for Lupus Erythematosus–Specific Skin Disease

First line vs Second line vs Short course only vs Third line vs Worth considering

Topical glucocorticoids

A

First line

22
Q

TABLE 61-6
Therapeutic Options for Lupus Erythematosus–Specific Skin Disease

First line vs Second line vs Short course only vs Third line vs Worth considering

Topical calcineurin inhibitor

A

First line

23
Q

TABLE 61-6
Therapeutic Options for Lupus Erythematosus–Specific Skin Disease

First line vs Second line vs Short course only vs Third line vs Worth considering

Intralesional triamcinolone acetonide

24
Q

TABLE 61-6
Therapeutic Options for Lupus Erythematosus–Specific Skin Disease

First line vs Second line vs Short course only vs Third line vs Worth considering

Hydroxychloroquine

A

Second line

25
Q

TABLE 61-6
Therapeutic Options for Lupus Erythematosus–Specific Skin Disease

First line vs Second line vs Short course only vs Third line vs Worth considering

Chloroquine

A

Second line

26
Q

TABLE 61-6
Therapeutic Options for Lupus Erythematosus–Specific Skin Disease

First line vs Second line vs Short course only vs Third line vs Worth considering

Quinacrine

A

Second line

27
Q

TABLE 61-6
Therapeutic Options for Lupus Erythematosus–Specific Skin Disease

First line vs Second line vs Short course only vs Third line vs Worth considering

Prednisone

A

Short course only (2-16 weeks)

28
Q

TABLE 61-6
Therapeutic Options for Lupus Erythematosus–Specific Skin Disease

First line vs Second line vs Short course only vs Third line vs Worth considering

Thalidomide

A

Short course only (2-16 weeks)

29
Q

TABLE 61-6
Therapeutic Options for Lupus Erythematosus–Specific Skin Disease

First line vs Second line vs Short course only vs Third line vs Worth considering

Azathioprine

A

Third line (safer immunosuppressives)

30
Q

TABLE 61-6
Therapeutic Options for Lupus Erythematosus–Specific Skin Disease

First line vs Second line vs Short course only vs Third line vs Worth considering

Mycophenolate mofetil

A

Third line (safer immunosuppressives)

31
Q

TABLE 61-6
Therapeutic Options for Lupus Erythematosus–Specific Skin Disease

First line vs Second line vs Short course only vs Third line vs Worth considering

Methotrexate

A

Third line (safer immunosuppressives)

32
Q

TABLE 61-6
Therapeutic Options for Lupus Erythematosus–Specific Skin Disease

First line vs Second line vs Short course only vs Third line vs Worth considering

Dapsone

A

Worth considering

33
Q

TABLE 61-6
Therapeutic Options for Lupus Erythematosus–Specific Skin Disease

First line vs Second line vs Short course only vs Third line vs Worth considering

Accutane

A

Worth considering

34
Q

TABLE 61-6
Therapeutic Options for Lupus Erythematosus–Specific Skin Disease

First line vs Second line vs Short course only vs Third line vs Worth considering

Acitretin

A

Worth considering

35
Q

TABLE 61-6
Therapeutic Options for Lupus Erythematosus–Specific Skin Disease

First line vs Second line vs Short course only vs Third line vs Worth considering

Gold

A

Worth considering

36
Q

TABLE 61-6
Therapeutic Options for Lupus Erythematosus–Specific Skin Disease

DOSE

Topical glucocorticoids, topical calcineurin inhibitor

A

Class I topical steroid daily to twice daily for 2 weeks alternating with pimecrolimus 1% or tacrolimus 0.1% twice daily for 2 weeks

37
Q

TABLE 61-6
Therapeutic Options for Lupus Erythematosus–Specific Skin Disease

DOSE

Intralesional triamcinolone acetonide

A

Intralesional triamcinolone acetonide 2.5-10 mg/cc

38
Q

TABLE 61-6
Therapeutic Options for Lupus Erythematosus–Specific Skin Disease

DOSE

Hydroxychloroquine

A

Hydroxychloroquine 6.5 mg/kg/day based on ideal body weight

39
Q

TABLE 61-6
Therapeutic Options for Lupus Erythematosus–Specific Skin Disease

DOSE

Chloroquine

A

Chloroquine 3-3.5 mg/kg/day based on ideal body weight

40
Q

TABLE 61-6
Therapeutic Options for Lupus Erythematosus–Specific Skin Disease

DOSE

Quinacrine

A

Quinacrine 100 mg/day

41
Q

TABLE 61-6
Therapeutic Options for Lupus Erythematosus–Specific Skin Disease

Second line
If monotherapy fails, add _____ to either _____ or _____

A

If monotherapy fails, add quinacrine to either hydroxychloroquine or chloroquine

42
Q

TABLE 61-6
Therapeutic Options for Lupus Erythematosus–Specific Skin Disease

DOSE

Prednisone

A

Prednisone 5-60 mg/day for 2-16 weeks

43
Q

TABLE 61-6
Therapeutic Options for Lupus Erythematosus–Specific Skin Disease

DOSE

Thalidomide

A

Thalidomide 50-200 mg/day; taper to 50 mg every other day on
response for 2-16 weeks

44
Q

TABLE 61-6
Therapeutic Options for Lupus Erythematosus–Specific Skin Disease

DOSE

Azathioprine

A

Azathioprine 1.5-2.5 mg/kg/day

45
Q

TABLE 61-6
Therapeutic Options for Lupus Erythematosus–Specific Skin Disease

DOSE

Mycophenolate mofetil

A

Mycophenolate mofetil 1-1.5 g/dose, twice daily

46
Q

TABLE 61-6
Therapeutic Options for Lupus Erythematosus–Specific Skin Disease

DOSE

Methotrexate

A

Methotrexate 7.5-25 mg by mouth or subcutaneously, once weekly

47
Q

TABLE 61-6
Therapeutic Options for Lupus Erythematosus–Specific Skin Disease

DOSE

Dapsone

A

Dapsone 50-200 mg/day

48
Q

TABLE 61-6
Therapeutic Options for Lupus Erythematosus–Specific Skin Disease

DOSE

Accutane

A

Accutane 0.5-2 mg/kg/day

49
Q

TABLE 61-6
Therapeutic Options for Lupus Erythematosus–Specific Skin Disease

DOSE

Acitretin

A

Acitretin 10-50 mg/day

50
Q

TABLE 61-6
Therapeutic Options for Lupus Erythematosus–Specific Skin Disease

DOSE

Gold

A

Gold titrate to 50 mg intramuscularly weekly, taper after 1 g

Fitzpatrick Tables (55 decks)

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