Systemic Lupus Erythematosus Flashcards
How many criteria (symptoms) must be met for a patient to be diagnosed with Lupus?
Must meet at least 4 criteria
What constitutional symptoms predominate in lupus?
Fatigue
Fever
weight loss
Does Lupus usually affect men or women more?
Overwhelming female predominance, approximately 9:1
What age does lupus usually start showing symptoms?
Typical onset during reproductive years
T/F There is a strong minority representation with lupus?
True
What are some triggers of lupus?
Recent sun exposure Emotional stress Infection Certain drugs (Clopidogrel, Hydralazine, Isoniazid, Procainamide, Ticlopidine, Minocycline) Surgery
T/F a patient with a positive ANA definitely has Lupus?
False.
A patient with a positive ANA but no other symptoms does not have a lupus
However, if a patient meets at least 4 criteria for lupus then they MUST have a positive ANA
What is the mucocutaneous presentation of lupus?
malar rash
discoid lesions
photosensitivity
oral ulcers
What lab findings are seen in a patient with lupus?
Labs:
ANA
hematologic (e.g., lymphopenia, leukopenia, hemolytic anemia, thrombocytopenia),
immunologic (e.g., anti-ds-DNA, anti-Smith, antiphospholipid antibodies),
What are some of the criteria that must be met with lupus diagnosis? (at least four)
Criteria (must meet at least four):
Mucocutaneous: malar rash, discoid lesions, photosensitivity, oral ulcers
Symptomatic organs: arthritis, serositis, neuropsychiatric, renal
Labs: ANA, hematologic (e.g., lymphopenia, leukopenia, hemolytic anemia, thrombocytopenia), immunologic (e.g., anti-ds-DNA, anti-Smith, antiphospholipid antibodies), nephritis (e.g., RBC casts, proteinuria)
Which system is the most commonly affected by lupus?
Cutaneous system most commonly affected (80%–90%)
Which of the skin conditions is considered chronic in lupus?
discoid lesions are chronic
Which rash is considered the ACUTE rash of lupus?
typical butterfly rash
Is an erythematous and edematous eruption
Seen on chin and forehead, not nasolabial folds
Which rash is considered the ACUTE rash of lupus?
typical butterfly rash
Is an erythematous and edematous eruption
Seen on chin and forehead, not nasolabial folds
Involves erythematous patches on nose and medial cheeks (malar), butterfly rash
Is photosensitive, may also involve dorsal hands, arms, trunk
Which race is the only one that experiences the subacute rash?
Caucasians females
Describe the subacute lesions seen in lupus?
typically symmetric, widespread, superficial, nonscarring
Seen most often in sun-exposed areas
Involves erythematous annular or polycyclic plaques with scaling (psoriasiform)
In sun-exposed areas, is possibility of smaller plaques and papules
Progresses to internal disease in 10%–15% of patients
Is strongly associated with anti-Ro antibodies (60%–100%)
Is associated with HLA-A1, B8, DR3
Can be triggered by drugs (HCTZ, Terbinafine, Griseofulvin, ACE inhibitors, calcium channel blockers, NSAIDs, Etanercept, Thalidomide, antihistamines)
NO SCARRING
Describe the discoid (chronic) lesions:
Seen typically on face, scalp, pinnae, behind ears, neck
Seen in non–sun-exposed areas
Can exist as part of systemic disease or in isolation
Presents central atrophic scarring with active indurated erythema at periphery
Can involve irreversible alopecia from follicular destruction
Does not go away and is SCARRING