DR Medhat MRCP

سؤال امتحان Discoid lupus erythematous
- Is a benign disorder generally seen in younger females.
- It very rarely progresses to systemic lupus erythematosus (in less than 5% of cases).
- Discoid lupus erythematous is characterised by follicular keratin plugs and is thought
to be autoimmune in aetiology
• Features
Erythematous, raised rash, sometimes scaly
May be photosensitive
More common on face, neck, ears and scalp
Lesions heal with atrophy, scarring (may cause scarring alopecia), and pigmentation
• Management
Topical steroid cream 1 st line.
Oral antimalarials may be used second-line e.g. hydroxychloroquine
Avoid sun exposure
Drug-induced lupus : (see the drugs before)
In drug-induced lupus not all the typical features of systemic lupus erythematosus are seen,
with renal and nervous system involvement being unusual. It usually resolves on stopping
the drug
• Features
Arthralgia
Myalgia
Skin (e.g. malar rash) and pulmonary involvement (e.g. pleurisy) are common.
ANA positive in 100%, dsDNA negative
Anti-histone antibodies are found in 80-90% (the most important)
Anti-Ro, anti-Smith positive in around 5%.
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