LUPUS ERYTHEMATOSUS

Question 1

CONCEPT

Answer 1

AUTOIMMUNE MULTISYSTEM DISEASE, CUTANEOUS/ORAL MANIFESTATIONS

Question 2

TARGET

Answer 2

PATIENTS PRODUCE AUTOANTIBODIES AGAINST VARIOUS CELLULAR ANTIGENS IN THE NUCLEUS AND THE CYTOPLASM LIKE ANTINUCLEAR ANTIBODIES (ANA) AND ANTI-DNA ANTIBODIES

Question 3

FORMS

Answer 3

1) DISCOID LUPUS ERYTHEMATOSUS (DLE)
2) SYSTEMIC LUPUS ERYTHEMATOSUS (SLE)

Question 4

DISCOID LUPUS ERYTHEMATOSUS (DLE)

Answer 4

• CHRONIC SKIN CONDITION OF SORES (INFLAMMATION/SCARRING AT FACE, EARS, SCALP, ORAL MUCOSA)
• SKIN: LESIONS DISK SHAPED, ATROPHIC (RED) AT THE CENTER WITH WHITE HYPERKERATOTIC MARGIN
• INTRAORALLY: ERYTHEMATOUS/ULCERATIVE LESIONS WITH DELICATE WHITE, KERATOTIC STRIAE RADIATING FROM THE PERIPHERY (MIMIC EROSIVE LICHEN PLANUS)
• BUCCAL MUCOSA, GINGIVA, VERMILION MOST AFFECTED

Question 5

SYSTEMIC LUPUS ERYTHEMATOSUS (SLE)

Answer 5

• CHRONIC INFLAMMATORY CONDITION INVOLVES MULTIPLE ORGAN SYSTEMS (KYDNEYS, HEART, LUNGS, JOINTS, SKIN, MUCOUS MEMBRANES, BLOOD VESSEL WALLS)
• WOMEN (8-10 TIMES MORE THAN MEN)
• GENERAL SYMPTOMES: FEVER, WEIGHT LOSS, ARTHRITIS, FATIGUE, GENERAL MALAISE
• KYDNEY LESIONS (GLOMERULONEPHRITIS & RENAL FAILURE) MOST COMMONLY RESPONSIBLE MORBIDITY/MORTALITY
• CLASSICAL SIGN: BUTTERFLY-SHAPED ERYTHEMATOUS RASH (MALAR RASH) ON THE FACE
• INTRAORAL LESIONS: SIMILAR DLE (ERYTHEMA, ULCERATION, KERATOSIS)

Question 6

HISTOLOGICALLY

Answer 6

• ORAL LESIONS SIMILARITY LICHEN PLANUS (DIFFICULT DIFFERENTIATE ROUTINE MICROSCOPIC EXAMINATION)
• DIFFERENTIATION: DIRECT IMMUNOFLUORESCENCE STUDIES/HISTOPATHOLOGIC EXAMINATION OF CUTANEOUS LESIONS

Question 7

PREVENT

Answer 7

PATIENTS AVOID EXCESSIVE EXPOSURE SUNLIGHT (UV LIGHT INCREASE ACTIVITY)

Question 8

TREATMENT

Answer 8

• DLE: TOPICAL CORTICOSTEROIDS/NSAIDs COMBINED WITH ANTIMALARIAL DRUGS (HYDROXYCHLOROQUINE)
• SLE: SYSTEMIC CORTICOSTEROIDS/IMMUNOSUPPRESSIVE DRUGS