Lupus Erythematosus

00:02 Let’s talk about lupus erythematosus, or systemic lupus erythematosus.

00:07 Now, this will come under three categories, so it is important that you pay attention to the organization of your lupus dermatology.

00:15 Three categories of cutaneous lupus.

00:18 Cutaneous lupus is my topic, clear? We’re not going to do the full systemic here.

00:23 Dermatology.

00:25 Acute SLE, this is the one that you’re oh so familiar with with the malar butterfly rash.

00:32 Is it affecting nasolabial type of region right here, the SLE? No, it does not.

00:38 That’s important.

00:40 You have another type.

00:41 Under cutaneous lupus is this called subacute lupus erythematosus.

00:48 It’s annular erythematous, and then it will be located on the sun exposed skin.

00:57 Often involves the arms and the neck because of exposure to the sun.

01:01 Associated with -- Please, make sure you memorize anti-Ro, which is SSA antibody.

01:07 The last time you’ve seen this was your Sjogren, wasn’t it? You saw SSB, which is your anti-La, and SSA, which is anti-Ro.

01:18 Memorize these.

01:20 May be caused by thiazides or other meds.

01:23 We’re referring to subacute lupus erythematosus.

01:27 What’s my topic? Cutaneous lupus erythematosus.

01:32 So far, we looked at two categories: acute and subacute.

01:37 What do you think is left? Voila! Chronic.

01:41 So, chronic cutaneous lupus erythematosus.

01:44 What’s my behavior here? Depigmentation, indurated or scarred plaques; chronic, chronic, chronic.

01:51 Surrounding hyperpigmenting or hyperpigmentation.

01:56 Most often affects the face and the scalp.

01:58 And has a prediliction for African-American women being most commonly affected.

02:04 My topic is cutaneous lupus erythematosus.

02:07 There are three categories.

02:08 The acute is the one that you’re quite familiar with with the butterfly malar rash.

02:12 Number two is the subacute, and number three would be the chronic.

02:19 If you'd notice here, on your left is acute systemic lupus erythematosus.

02:25 You have that beautiful butterfly rash.

02:26 We call this malar or should I say the characteristic.

02:30 You’ll notice here that the nasolabial margin or fold has been spared.

02:36 Then we have the subacute cutaneous lupus erythematosus, which is the middle picture.

02:42 And here, you’ll notice the sun exposed areas, either it’d be the arm, maybe the chest in this particular patient.

02:49 And finally, you have your chronic cutaneous lupus erythematosus.

02:53 This is the one in which -- please take a look at the scalp of this patient, and you’ll notice that there is deep pigmentation surrounded by areas that are hyperpigmented, or maybe perhaps, erythematosus.

03:05 Where else would you find this? Maybe perhaps, on your face.

03:08 Most commonly, with chronic, it would be which population? An African-American lady.

03:17 Other: The malar rash is present with SLE.

03:21 The subacute type of cutaneous lupus erythematosus may have systemic complications, and the chronic has systemic complications.

03:31 A small percentage of the time as well.

03:33 Here’s my acute, subacute, and chronic, all in terms of percentage of systemic involvement.

03:44 Management: Evaluation of systemic disease.

03:48 Always suspect lupus erythematosus.

03:51 You want to make sure that the systemic organs are doing okay.

03:55 Referral to a dermatologist or rheumatologist.

03:58 We have steroids, and maybe perhaps, antimalarials, and sun protection, all being possible measures of management of lupus erythematosus.