1
|
Samanta J, Chattopadhyay A, Mishra D, De D, Jain S. Carpet Tack Sign. Mediterr J Rheumatol 2021; 32:278-279. [PMID: 34964034 PMCID: PMC8693291 DOI: 10.31138/mjr.32.3.278] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2020] [Revised: 02/03/2021] [Accepted: 02/07/2021] [Indexed: 11/19/2022] Open
Affiliation(s)
- Joydeep Samanta
- Clinical Immunology and Rheumatology Unit, Post Graduate Institute of Medical Education and Research, Chandigarh, Punjab, India
| | - Arghya Chattopadhyay
- Clinical Immunology and Rheumatology Unit, Post Graduate Institute of Medical Education and Research, Chandigarh, Punjab, India
| | - Debashish Mishra
- Clinical Immunology and Rheumatology Unit, Post Graduate Institute of Medical Education and Research, Chandigarh, Punjab, India
| | - Dipankar De
- Department of Dermatology, Post Graduate Institute of Medical Education and Research, Chandigarh, Punjab, India
| | - Sanjay Jain
- Clinical Immunology and Rheumatology Unit, Post Graduate Institute of Medical Education and Research, Chandigarh, Punjab, India
| |
Collapse
|
2
|
Timpane S, Brandling-Bennett H, Kristjansson AK. Autoimmune collagen vascular diseases: Kids are not just little people. Clin Dermatol 2016; 34:678-689. [PMID: 27968927 DOI: 10.1016/j.clindermatol.2016.07.002] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/11/2023]
Abstract
Morphea, dermatomyositis (DM), and discoid lupus erythematosus (DLE) are autoimmune collagen vascular diseases that can present at any age. In all three of these diseases, the tenants of diagnosis and treatment are largely the same in both children and adults, with a few notable differences. Children with morphea are more likely to present with the linear subtype and have a higher incidence of extracutaneous manifestations. Children often need early aggressive systemic treatment to try to prevent long-term sequelae of morphea. In DM, adult disease has a clear association with malignancy that is not seen in children. Adults have a higher rate of pulmonary involvement and increased mortality, whereas calcinosis is more common in juvenile DM. DLE in adults is generally considered to have a low rate of progression from discoid lesions alone to systemic lupus erythematosus (SLE). DLE is less common in children, but several studies have suggested a higher rate of progression from DLE to SLE in children compared with adults.
Collapse
Affiliation(s)
- Sean Timpane
- Resident, Department of Pediatrics, University of Washington School of Medicine, Seattle Children's Hospital, Seattle, WA
| | - Heather Brandling-Bennett
- Assistant Professor, Department of Pediatrics, Division of Dermatology, University of Washington School of Medicine, Seattle Children's Hospital, Seattle, WA
| | - Arni K Kristjansson
- Assistant Professor of Dermatology, University of Connecticut School of Medicine, Farmington, CT
| |
Collapse
|
3
|
Xie Y, Jinnin M, Zhang X, Wakasugi S, Makino T, Inoue Y, Fukushima S, Masuguchi S, Sakai K, Ihn H. Immunohistochemical characterization of the cellular infiltrate in discoid lupus erythematosus. Biosci Trends 2011; 5:83-8. [PMID: 21572252 DOI: 10.5582/bst.2011.v5.2.83] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Discoid lupus erythematosus (DLE) is a chronic connective tissue disease of unknown etiology, but immunologic factors may play an important role in the pathogenesis. We investigated the features of immunohistochemical characterization of the cellular infiltrate in DLE. Skin samples were obtained from 5 patients using a 6 mm punch biopsy. Samples were stained with monoclonal antibodies against CD1a, CD3, CD4, CD8, CD20, CD25, CD30, and CD57. The number of cells stained with each monoclonal antibody was calculated. The number of cells stained with each monoclonal antibody in the dermis infiltration in DLE was calculated and all were higher than those in the normal control. The numbers of CD3(+), CD4(+), CD8(+), CD20(+), CD25(+), or CD57(+) cells in DLE were statistically higher than those in normal skin (p < 0.05). The numbers of CD1a(+) and CD30(+) cells in DLE were appreciably increased but had no statistical significance compared with normal skin. In conclusion, this study revealed that T lymphocytes, B lymphocytes, and natural killer cells may play some roles in the pathogenesis of DLE.
Collapse
Affiliation(s)
- Yong Xie
- Department of Dermatology & Plastic Surgery, Faculty of Life Sciences, Kumamoto University, Japan
| | | | | | | | | | | | | | | | | | | |
Collapse
|
4
|
Hansen CB, Callen JP. Connective tissue panniculitis: lupus panniculitis, dermatomyositis, morphea/scleroderma. Dermatol Ther 2010; 23:341-9. [DOI: 10.1111/j.1529-8019.2010.01334.x] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/13/2023]
|
5
|
Wu CY, Chiang CP. Clinicopathologic challenge: multiple tender lesions on both upper extremities and the back. Int J Dermatol 2010; 49:380-1. [DOI: 10.1111/j.1365-4632.2010.04289.x] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
|
6
|
Lee HJ, Sinha AA. Cutaneous lupus erythematosus: understanding of clinical features, genetic basis, and pathobiology of disease guides therapeutic strategies. Autoimmunity 2007; 39:433-44. [PMID: 17060022 DOI: 10.1080/08916930600886851] [Citation(s) in RCA: 42] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
Cutaneous features of the protean disease lupus erythematous (LE) constitute 4 of 11 diagnostic criteria for systemic lupus erythematosus (SLE) and are exhibited by approximately 3/4 of patients during the course of their disease. Because the pathogenesis of LE is multifactorial and polygenic, many of the details of the pathogenesis remain unclear. We review here the clinical features of cutaneous lupus and recent genetic data that elucidate potential candidate genes for both cutaneous lupus erythematosus (CLE) and SLE. We discuss advances in elucidating the autoimmune pathogenesis of CLE and SLE. Furthermore, promising experimental therapies based on these advances are reviewed in the context of B cell directed therapies, T cell directed therapies, disruption of B and T cell interactions, cytokine directed therapies and finally, end-effector targeted therapies.
Collapse
Affiliation(s)
- Henry J Lee
- Department of Dermatology, Weill Medical College of Cornell University, 525 East 68th Street Rm F-340, New York, NY 10021, USA
| | | |
Collapse
|
7
|
Moises-Alfaro C, Berrón-Pérez R, Carrasco-Daza D, Gutiérrez-Castrellón P, Ruiz-Maldonado R. Discoid lupus erythematosus in children: clinical, histopathologic, and follow-up features in 27 cases. Pediatr Dermatol 2003; 20:103-7. [PMID: 12657003 DOI: 10.1046/j.1525-1470.2003.20201.x] [Citation(s) in RCA: 49] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
Among 27 pediatric patients with a clinicopathologic diagnosis of discoid lupus erythematosus (DLE), 15 had localized cutaneous lesions and 12 had disseminated lesions. During a mean follow-up period of 36 months, seven patients (26%) developed systemic lupus erythematosus (SLE). Four of these patients were less than 10 years of age. No correlation was found between localized and disseminated lesions and evolution to SLE. Three of four patients with a positive family history for rheumatoid disease developed SLE (p < 0.05). Hyperpigmentation was significantly more frequent (p < 0.04) in children less than 10 years of age. There was a female predominance of 5:1 among patients less than 10 years of age. Our findings suggest that onset of DLE prior to 10 years of age does not indicate a greater risk of developing SLE. The occurrence of localized or disseminated lesions does not seem to influence the outcome.
Collapse
Affiliation(s)
- Celia Moises-Alfaro
- Department of Pediatric Dermatology, National Institute of Pediatrics, Mexico City, Mexico
| | | | | | | | | |
Collapse
|
8
|
Abstract
This article will review and update information about the pathogenesis, clinical presentation, diagnosis, and treatment of cutaneous lupus erythematosus. Lupus erythematosus (LE) can present as a skin eruption, with or without systemic disease. Cutaneous LE is subdivided into chronic cutaneous LE, subacute cutaneous LE and acute LE. The prevalence of systemic lupus erythematosus (SLE) is 17-48/100,000 population worldwide. Skin disease is one of the most frequent clinical complaints of patients suffering from SLE. It has been found to occur in up to 70% of patients during the course of the disease. The most frequent mucocutaneous manifestations of SLE are malar rash (40%), alopecia (24%), and oral ulcers (19%). It has been suggested that risk factors that are more likely to signal transition of cutaneous into systemic LE are high ANA titers (> 1:320) and the presence of arthralgias. CLE patients who exhibit these symptoms should be monitored closely, since they may be at increased risk to develop SLE.
Collapse
|
9
|
Abstract
Discoid lupus erythematosus is a manifestation of chronic cutaneous lupus erythematosus with a small risk of systemic involvement. In this review article, the role of predisposing factors such as haplotype, hormones, antibodies and sunlight are discussed. The clinical features, including variants and associations, and management options are presented.
Collapse
Affiliation(s)
- A M Donnelly
- Department of Dermatology, Royal Perth Hospital, Australia
| | | | | |
Collapse
|
10
|
Affiliation(s)
- P G Fotos
- Department of Oral Pathology, Radiology, and Medicine, University of Iowa College of Dentistry, Iowa City 52242
| | | |
Collapse
|
11
|
Beutner EH, Blaszczyk M, Jablonska S, Chorzelski TP, Kumar V, Wolska H. Studies on criteria of the European Academy of Dermatology and Venerology for the classification of cutaneous lupus erythematosus. I. Selection of clinical groups and study factors. Int J Dermatol 1991; 30:411-7. [PMID: 1894405 DOI: 10.1111/j.1365-4362.1991.tb03896.x] [Citation(s) in RCA: 46] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
A group of 140 cases of various forms of lupus erythematosus (LE) were examined for 24 variables, including the 11 criteria of the American Rheumatism Association (ARA) for the classification of systemic lupus erythematosus (SLE), and 13 additional criteria suggested by the European Academy of Dermatology and Venerology (EADV) for studies of cutaneous LE with or without systemic involvement. The EADV study factors included skin histopathology and immunopathology, complement and IgG levels, and other laboratory tests, as well as selected clinical findings, most notably the papulosquamous and/or annular lesions that characterize subacute cutaneous LE (SCLE). The patients examined included 50 SLE, 35 SCLE, 30 discoid LE (DLE), 25 disseminated DLE (DDLE), and 17 polymorphous light eruption (PMLE) cases. Preliminary analyses of the data reveal the following: (1) The SCLE cases differed significantly from SLE, DLE, and DDLE in 10 of 11 ARA criteria (all but photosensitivity). (2) The frequencies of positive findings in SCLE also differed significantly for 11 of 13 EADV study factors. (3) While no significant differences appeared in the frequency of photosensitivity between the five study groups, photo-testing revealed significant increases in the frequency of persistence of the photo reactions for 10 days and their Koebnerization in the SCLE cases. (4) The presence of SS-A (Ro)/SS-B (La) antibodies had some predictive value for the appearance of systemic involvement in SCLE, as seen by the increased frequencies of five or more ARA criteria, although highly significant differences from SLE occurred in the absence of renal involvement and lower frequency of ANA and LE band test.(ABSTRACT TRUNCATED AT 250 WORDS)
Collapse
Affiliation(s)
- E H Beutner
- Department of Microbiology, State University of New York, Buffalo School of Medicine and Biomedical Science
| | | | | | | | | | | |
Collapse
|