Cutaneous Manifestations of Systemic Lupus Erythematosus (SLE)

Chronic Cutaneous Lupus Erythematosus (CCLE) – Discoid Lupus Erythematosus (DLE)

Systemic Lupus Erythematosus (SLE) is an autoimmune condition that can affect multiple organ systems. Among its many manifestations, cutaneous symptoms are highly prevalent. Chronic Cutaneous Lupus Erythematosus (CCLE), specifically Discoid Lupus Erythematosus (DLE), is a form of lupus that primarily affects the skin.

Clinical Presentation

DLE presents as erythematous, scaly plaques, often on sun-exposed areas such as the face, ears, and scalp. Lesions can result in scarring and permanent hair loss. These cutaneous manifestations tend to be more localized and do not commonly involve systemic organ damage.

Etiology & Pathogenesis

The exact cause of DLE remains unclear. However, genetic predisposition, environmental factors, and immune dysregulation play key roles. Exposure to ultraviolet (UV) light is known to exacerbate the condition, indicating photosensitivity as a significant trigger.

Diagnosis

Diagnosis is based on clinical examination, skin biopsy findings, and laboratory tests. A biopsy may reveal vacuolar interface dermatitis, perivascular lymphocytic infiltrates, and basement membrane thickening.

Treatment & Management

• Topical corticosteroids and calcineurin inhibitors for localized lesions
• Systemic therapies like antimalarials (e.g., hydroxychloroquine) for more extensive disease
• Sun protection measures, including broad-spectrum sunscreen and protective clothing
• Immunosuppressive agents in refractory cases

Prognosis

DLE may cause chronic skin damage but is not commonly associated with systemic involvement. However, around 5-10% of patients with DLE may develop systemic lupus erythematosus (SLE).