CTD: Lupus. Lecture review Qs Flashcards
what medication unmasks true SLE
penicillamine
medications implicated in drug-induced SLE
MMC is HIP Minocycline Methyldopa Chlorpromazine Hydralazine Isoniazid Procainamide Phenytoin
immunologic markers for renal disease in SLE
anti-dsDNA
anti-C1q
what is Sneddon syndrome
livedo reticularis, cerebrovascular infarcts and htn (may have SLE)
treatment of bullous SLE
dapsone
what does bullous SLE attack? HLA associated?
type 7 collagen
HLA-DR2
what does ASAP syndrome stand for and what is it
Acute Syndrome of Apoptotic Pan-Epidermolysis
TEN-like presentation in SLE
what is Rowell syndrome
EM-like lesions in lupus
11 criteria for SLE
SOAP BRAIN MD Serositis Oral ulcerations Arthritis Pleuritis Blood abnormalities Renal abnormalities ANA + Immunologic abnormalities Neurologic abnromalities Malar rash Discoid lesions
who does SLE affect
young-middle age women (6:1) and African Americans (4:1)
clinical presentation of neonatal lupus
periocular edema and erythema (racoon’s eyes)
appear in first few weeks of life
associations in neonatal lupus
congenital heart block, thrombocytopenia, hepatobiliary ds
if only __ ab is present in neonatal lupus, then there is no risk of heart block
U1RNP
what medication can lower the risk of neonatal lupus to 7% if initiated prior to 10 wks gestation
hydroxychloroquine
what is the risk that a second child will have neonatal lupus
25%
neonatal lupus is due to transferring __ ab across the placenta
anti-Ro/SSa
most important treatment for DLE and SCLE
sunscreen
30% of SCLE cases are drug-induced. what drugs?
HANG NAIL HCTZ ACE-I and Antihistamines NSAIDs Griseofulvin Nifedipine Anticonvulsants Interferon Lamisil
clinical description of SCLE
sun exposed scaly, annular plaques
10-15% of SCLE pts develop internal symptoms. what are they?
arthritis, leukopenia, renal, CNS, vascular complications
antibody in 70% SCLE pts
anti Ro/SSa
percentage of pts with positive ANA in SCLE
80%
percentage of pts with SCLE that will get SLE
30%
anatomical area spared in lupus panniculitis
distal extremities
percentage of pts with tumid lupus that will have overlying DLE
30%
percentage of pts with tumid lupus that will develop SLE
50%
tumid lupus overlaps with what entities
REM (reticular erythematous mucinosis)
jessner’s lymphocytic infiltrate
how often does tumid lupus have overlying epidermal involvement
never
mutation in familial form of chilblain lupus
TREX1
LE-LP overlap syndrome most commonly affects what area
palmoplantar
also oral with scarring alopecia
percentage of pts with DLE that have +DIF
75%
percentage of SLE pts with DLE
25%
percentage of DLE pts that develop SLE
5-15%
childhood DLE has higher progression to?
SLE
what do you need to worry about in long-standing DLE
SCC
most common location DLE
above the neck - scalp and concha
langue au chat refers to
cat’s tongue - follicular carpet tack like plugging in DLE
forms of chronic cutaneous lupus
discoid, hypertrophic, LE-LP overlap, chilblain, tumid, lupus panniculitis
other name for Sjogren syndrome
Sicca syndrome, Mikulicz ds
