Lupus and DM

Question 1

discoid LE aka…

Answer 1

chronic cutaneous LE

Question 2

describe discoid lesions

Answer 2

indurated erythematous thin papules with adherent scale and follicular plugging

Question 3

what is the “capet tack” sign

Answer 3

follicular plugs with removal of scale

Question 4

what do discoid lesions leave behind?

Answer 4

atrophy, telangectasias, dyschromia, scarring SCC can develop in scars

Question 5

describe classic histology of DLE

Answer 5

atropic epidermis with follicular plugging
vacuolar degeneration of basal layer
perivascular with periadnexal lymphocytic infiltrate
inc mucin

Question 6

% DLE that progresses to SLE

Answer 6

5-10%

Question 7

treatment of DLE

Answer 7

sun avoidance
topical or IL steorids
antimalarials
topical calcineurin inhibitors

Question 8

C2 deficiency a/w…

Answer 8

increase susceptibility to autoimmune conditions, esp lupus

Question 9

pathophys of neonatal lupus

Answer 9

transplacental passage of anti-Ro/SSA abs (less commonly anti-La/SSB

Question 10

Ab a/w higher mortality rate in neonatal lupus

Answer 10

anti-U1-RNP

Question 11

when does neonatal lupus present and when does it resolve

Answer 11

presents in first few months of life and resovles spontaneously within 6 months w/o scarring

Question 12

neonatal lupus is a/w

Answer 12

heart block
thrombocytopenia
transaminitis

Question 13

describe SCLE lesions

Answer 13

papulosquamous or annular/polycyclinc erythematous scaly patches/plaques on shoulders, trunk, extensor arms (spares face typicallY)

Question 14

Abs a/w SCLE

Answer 14

60-80% + ANA

60-90% + anti-Ro

Question 15

what % will eventually meet SLE criteria

Answer 15

50%

Question 16

HLA associated with SCLE

Answer 16

B8&raquo_space; DR3&raquo_space; DRw2, DQ1

Question 17

drugs that can cause drug induced SCLE

Answer 17

HCTZ
terbinafine, griseofulvin
diltiazem
ACEi
NSAIDs 
INF/TNFa 
PUVA

Question 18

drugs that cause SLE

Answer 18

hydralazine
procainamide
chlorpromazine 
INH
quinidine 
practolol
D-penicilliamine
PUVA
minocycline

Question 19

Diagnostic criteria for SLE

Answer 19

4 off 11 criteria
MD SOAP BRAIN
-  Malar rash
- Discoid rash
- Serositis
- Oral ulcers
- Arthritis 
- Photosensitivity 
- Blood (heme)
- Renal 
- ANA 
- Immuno abnormality 
- Neurologic

Question 20

multiple dermatofibromas a/w

Answer 20

SLE

Question 21

Abs that are highly specific for SLE

Answer 21

anti-dsDNA, anti-Sm

Question 22

HLA associations with SLE

Answer 22

DR2, DR3

Question 23

timing of skin lesions in DM with muscle weakness

Answer 23

skin lesions 2-3 months before muscle weakness

Question 24

grotton’s papules vs grotton’s sign

Answer 24

papules = violaceous papules over MP joints
sign = red scaling over knuckles, knees, elbows

Question 25

what is samitz sign

Answer 25

ragged cuticles

Question 26

hyperkeratosis and fissuring of hands

Answer 26

mechanic’s hands

Question 27

what finding in DM is more common in juvenille DM

Answer 27

calcinosis

Question 28

what is heliotrope sign

Answer 28

poikioderma of eyelids with edema

Question 29

what nail findings in DM

Answer 29

ragged cuticles, nailfold telangectasias

Question 30

what cancers are a/w DM

Answer 30

lung, GI, ovarian and breast