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Published in Ashfaq A Marghoob, Ralph Braun, Natalia Jaimes, Atlas of Dermoscopy, 2023
Anna Waśkiel-Burnat, Lidia Rudnicka, Małgorzata Olszewska, Adriana Rakowska, Ralph M. Trüeb, Isabel Kolm
Discoid lupus erythematosus (chronic cutaneous lupus erythematosus) presents as erythematous scaly plaques with follicular plugs, telangiectasias, and progressive central scarring. Histopathology reveals a lymphocytic scarring alopecia. Trichoscopic features of discoid lupus erythematosus include loss of follicular ostia, thick arborizing vessels (Figures11e.12, 11e.13), follicular keratotic plugs (big yellow dots) (Figure 11e.3), and scalp atrophy, occasionally with effaced or absent vascular loops (Figure 11e.14).34
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Published in Sarah Bekaert, Women's Health, 2018
Discoid lupus erythematosus – a chronic skin condition characterised by inflammation and scarring skin lesions on the face, ears and scalp and sometimes on other body areas. These lesions develop as an inflamed growth with scaling and a wart-like appearance. The central area may appear lighter in colour, surrounded by an area that is darker than the normal skin. A small percentage of cases develop disease of the internal organs, which can cause systemic symptoms.
Pathological relevance and treatment perspective of JAK targeting in systemic lupus erythematosus
Published in Expert Review of Clinical Immunology, 2022
Shingo Nakayamada, Yoshiya Tanaka
To date, three clinical trials have been conducted with tofacitinib; a phase Ib trial was initiated in 2015 with the primary endpoint of evaluating the safety of tofacitinib in SLE [NCT02535689] (Table 1). The study evaluated the safety and tolerability of tofacitinib in patients with mild to moderate SLE, stratified by the presence or absence of STAT4 risk alleles, and compared placebo or tofacitinib 10 mg treatment with standard therapy. In this study, most of the adverse events (AEs) with tofacitinib were mild and moderate upper respiratory tract infections, and reactivation of herpes zoster and venous thromboembolism were not reported [52]. However, since the study was conducted in a limited number of patients (n = 30), further studies are needed. Two phase I/II trials are ongoing in patients with discoid lupus erythematosus (DLE) [NCT03159936], cutaneous lupus erythematosus (CLE), and SLE with moderate to severe skin symptoms [NCT03288324] (Table 1).
Assessing the EULAR/ACR classification criteria for patients with systemic lupus erythematosus
Published in Expert Review of Clinical Immunology, 2022
Martin Aringer, Karen Costenbader, Sindhu R Johnson
Compared to the SLICC criteria [41], the extended lists of mucocutaneous and neuropsychiatric manifestations were reduced for the EULAR/ACR criteria [4,5]. While acute, subacute, and discoid lupus erythematosus are included, as are alopecia and oral ulcers [1,2], some dermatologists were concerned that this reduction would impact on sensitivity. In the end, however, even in a large specialized cohort, there were only five patients with manifestations uncommon for SLE, namely, two with lupus tumidus and one each with lupus panniculitis, bullous lupus, and Chilblain lupus, who would not have been classifiable by the EULAR/ACR criteria [52]. Likewise, the more specific neuropsychiatric manifestations other than seizures, psychosis, and delirium, the latter of which already being rather uncommon at 1.8% and 0.4% sensitivity in the EULAR/ACR cohort [13], play only a relatively minor role for classification [34].
Skin diseases of the vulva: inflammatory, erosive-ulcerating and apocrine gland diseases, zinc and vitamin deficiency, vulvodynia and vestibulodynia
Published in Journal of Obstetrics and Gynaecology, 2018
Freja Lærke Sand, Simon Francis Thomsen
Discoid lupus erythematosus is a chronic disease affecting the skin especially in sun-exposed areas. However, vulvar lesions may be encountered in 5% of women with the disease and are associated with significant morbidity (Burge et al. 1989). Discoid lupus erythematosus is characterised by pain and itching and appearance of erythematous plaques on the skin in the vulvar area, which in chronic cases may result in atrophic scarring (Figure 9). In addition, erosions and lichen planus-like mucosal lesions have been described (Burge et al. 1989). Histopathological signs are hydropic basal cell degeneration, thickening of the basement membrane, hyperkeratosis with follicular plugging and dermal perivascular infiltrate of lymphocytes and histiocytes. Deposits of mucin are usually found in the dermis. Therapy is ultrapotent topical corticosteroids, antimalarials and in severe cases other immunosuppressants such as azathioprine, mycophenolate mofetil or prednisolone.