Collagen Vascular Diseases: Cutaneous Manifestations in Systemic Lupus Erythematosus (SLE)
Subacute Cutaneous Lupus Erythematosus (SCLE)
SCLE is a photosensitive skin disorder linked to SLE, characterized by annular and psoriasiform lesions. Proper diagnosis and management are crucial for patient care.
Collagen Vascular Diseases: Cutaneous Manifestations in Systemic Lupus Erythematosus (SLE)
Subacute Cutaneous Lupus Erythematosus (SCLE)
Subacute Cutaneous Lupus Erythematosus (SCLE) is a non-scarring, photosensitive dermatosis associated with systemic lupus erythematosus (SLE). It presents with distinctive annular or papulosquamous lesions and often occurs in sun-exposed areas.
Clinical Features
- Annular, erythematous plaques with central clearing
- Psoriasiform, scaly plaques resembling psoriasis
- Commonly affects the upper back, shoulders, and extensor surfaces
- Strong photosensitivity observed
Pathophysiology
SCLE is associated with anti-Ro/SSA antibodies and often occurs in response to environmental triggers, including ultraviolet (UV) radiation and certain medications. The condition may be induced or exacerbated by drugs such as thiazides and calcium channel blockers.
Diagnosis
Diagnosis is based on clinical examination, serological testing, and histopathological analysis. Key diagnostic markers include:
- Positive anti-Ro/SSA antibodies
- Interface dermatitis with epidermal atrophy on biopsy
- Absence of lupus nephritis
Treatment and Management
Therapeutic approaches involve photoprotection, topical corticosteroids, and systemic immunomodulatory agents, including hydroxychloroquine and methotrexate.
Conclusion
SCLE is a significant cutaneous manifestation of SLE requiring careful diagnosis and tailored treatment strategies to prevent exacerbations and long-term complications.