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Kürkçüoğlu N, Sahin S. PUVA-induced discoid lupus erythematosus in a patient with vitiligo. J Am Acad Dermatol 1991; 24:515. [PMID: 2061464 DOI: 10.1016/s0190-9622(08)80093-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
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27
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Lehmann P, Hölzle E, Kind P, Goerz G, Plewig G. Experimental reproduction of skin lesions in lupus erythematosus by UVA and UVB radiation. J Am Acad Dermatol 1990; 22:181-7. [PMID: 2179293 DOI: 10.1016/0190-9622(90)70020-i] [Citation(s) in RCA: 222] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
Sunlight is a well-established factor in the induction and exacerbation of lupus erythematosus. Although experimental reproduction of lupus erythematosus lesions with wavelengths shorter than 320 nm was demonstrated previously, the effect of wavelengths longer than 320 nm was not investigated adequately. In this study we show that the action spectrum of lupus erythematosus reaches into the UVA region. A total of 128 patients with lupus erythematosus underwent phototesting with the use of polychromatic UVB and long-wave UVA. Subsets of the disease consisted of discoid lupus erythematosus (n = 86), subacute cutaneous lupus erythematosus (n = 22), and systemic lupus erythematosus (n = 20). Skin lesions clinically and histologically compatible with lupus erythematosus were induced in 64% of patients with subacute cutaneous lupus erythematosus, 42% of patients with discoid lupus erythematosus, and 25% of patients with systemic lupus erythematosus. The action spectrum of the induced lesions was within the UVB range in 33% of patients, in the UVA range in 14%, and in the UVB and UVA range in 53%. In positive test reactions patchy dark erythema and urticarial plaques developed within a few days. In some patients typical discoid lesions persisted for months.
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28
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Kind P, Lehmann P. [Photobiology of lupus erythematosus]. DER HAUTARZT 1990; 41:66-71. [PMID: 2180856] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
Photosensitivity is one of the criteria of the American Rheumatism Association for the diagnosis of systemic lupus erythematosus. Although UV irradiation is a major factor in the pathogenesis of photosensitive cutaneous lupus erythematosus, so far the exact pathomechanism is unknown. The following review presents historical, clinical and experimental data on the photobiology of cutaneous lupus erythematosus.
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Abstract
Chronic cutaneous LE is a diverse disease, characterized by predominantly cutaneous disease with few systemic complications. Discoid lesions are commonly seen, but they are not specific for chronic cutaneous LE. These scarring and disfiguring changes are also present in neonatal LE, SLE, and complement deficiency LE. Because definitive diagnosis cannot be made by cutaneous examination alone, all patients should initially be evaluated for systemic disease. A small percentage of patients with chronic cutaneous LE will ultimately develop SLE, and therefore, patients should be re-evaluated periodically. The pathogenesis of the cutaneous lesions is not definitively known. There is suggestive evidence implicating T-cell mediated injury, especially in discoid LE. Antibody-dependent cellular cytotoxicity may also play a significant role in cellular damage in subacute cutaneous LE and neonatal LE, especially in the presence of anti-Ro antibody. Immunoglobulin deposition in association with membrane attack complex, has been associated with epidermal injury in some cases. Treatment of chronic cutaneous LE is largely symptomatic and nonspecific, focusing on reduction of inflammation. Further knowledge of pathogenesis will, hopefully, provide for specific immunologic therapy.
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31
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Tuffanelli DL. Antinuclear antibodies and photosensitivity in lupus erythematosus--relevant in PUVA therapy? J Am Acad Dermatol 1987; 16:614-6. [PMID: 3493273 DOI: 10.1016/s0190-9622(87)80092-0] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
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33
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Stalder JF, Dreno B, Bureau B, Hakim J. Discoid lupus erythematosus-like lesions in an autosomal form of chronic granulomatous disease. Br J Dermatol 1986; 114:251-4. [PMID: 3947541 DOI: 10.1111/j.1365-2133.1986.tb02805.x] [Citation(s) in RCA: 20] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
Chronic granulomatous disease (CGD) is characterized by a bactericidal defect involving the oxidative metabolism of polymorphonuclear leukocytes (PML) and is most often transmitted as an X-linked trait. The cutaneous features of this disorder include infections and lupus-like rashes. These have been described in female carriers as well as in males with the disease. Two cases of siblings presenting an autosomal form of CGD syndrome, with lupus-like cutaneous manifestations, are reported here.
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34
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Lee LA, Weston WL. Lupus erythematosus in childhood. Dermatol Clin 1986; 4:151-60. [PMID: 3521977] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
Abstract
Lupus erythematosus in childhood comprises the following distinctive lupus subsets: neonatal lupus erythematosus, systemic lupus erythematosus, discoid lupus erythematosus, subacute cutaneous lupus erythematosus, complement deficiency syndromes with subacute cutaneous lupus lesions, and lupus panniculitis. The clinical features and pathogeneses of each of these lupus syndromes is discussed in this review.
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MESH Headings
- Antibodies, Antinuclear/immunology
- Autoantigens/immunology
- Child
- Child, Preschool
- Complement System Proteins/deficiency
- Female
- Heart Block/congenital
- Humans
- Infant, Newborn
- Lupus Erythematosus, Discoid/diagnosis
- Lupus Erythematosus, Discoid/etiology
- Lupus Erythematosus, Discoid/immunology
- Lupus Erythematosus, Systemic/diagnosis
- Lupus Erythematosus, Systemic/etiology
- Lupus Erythematosus, Systemic/immunology
- Male
- Panniculitis, Nodular Nonsuppurative/diagnosis
- Prognosis
- RNA, Small Cytoplasmic
- Ribonucleoproteins
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35
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Callen JP. Systemic lupus erythematosus in patients with chronic cutaneous (discoid) lupus erythematosus. Clinical and laboratory findings in seventeen patients. J Am Acad Dermatol 1985; 12:278-88. [PMID: 3871800 DOI: 10.1016/s0190-9622(85)80036-0] [Citation(s) in RCA: 58] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Abstract
The presence of the discoid lupus erythematosus (DLE) skin lesion in a patient with systemic lupus erythematosus (SLE) has been suggested to be a marker of less frequent and less severe renal disease. The clinical and laboratory features of seventeen patients who were seen in a dermatology practice and who had DLE as a manifestation of SLE (DLE-SLE) are reported. DLE preceded the diagnosis of SLE in eight patients. In six patients, the onset was concurrent, whereas in three the SLE was present prior to the discoid skin lesions. Five of the patients had lesions of subacute cutaneous lupus erythematosus (SCLE), and Raynaud's phenomenon occurred in eight patients. Clinical evidence of a renal abnormality was present in six patients (hematuria in three, proteinuria in five, and abnormal renal function in two). Antibodies to nuclear and/or cytoplasmic components were abnormal in all patients. Antibody subsets did not correlate well with clinical findings; only half of those with Raynaud's phenomenon demonstrated a positive ribonucleoprotein; only one patient with SCLE demonstrated anti-Ro (SSA) antibody, but four of the six patients with a renal abnormality had an elevated anti-native deoxyribonucleic acid antibody titer. The cutaneous lesions were eventually widespread in all patients, although two had initial disease that was localized to the head and neck. Although renal disease occurs in this group, it is less common and usually milder than in previous groups of unselected SLE patients.
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36
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Tsvetkov EA. [Senear-Usher syndrome as a complication of radiotherapy of laryngeal cancer]. MEDITSINSKAIA RADIOLOGIIA 1983; 28:76-7. [PMID: 6865690] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
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37
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38
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Skendzić M, Blagojević D, Gajić M. [Disappearance of chronic erythematosus after focal removal]. SRP ARK CELOK LEK 1982; 110:1523-8. [PMID: 7185199] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/23/2023] Open
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39
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Brandrup F, Koch C, Petri M, Schiødt M, Johansen KS. Discoid lupus erythematosus-like lesions and stomatitis in female carriers of X-linked chronic granulomatous disease. Br J Dermatol 1981; 104:495-505. [PMID: 7236510 DOI: 10.1111/j.1365-2133.1981.tb08163.x] [Citation(s) in RCA: 64] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/24/2023]
Abstract
The skin and oral mucosa were studied in an unselected series of carriers of x-linked chronic granulomatous disease, a hereditary condition in which phagocytic cells display a pronounced functional defect. Three carriers had discoid lupus erythematosus (DLE)-like skin lesions which histopathologically were consistent with DLE of the hypertrophic and profundus type. Four patients had experienced photosensitivity in childhood. Seven patients had recurrent aphthous-like stomatitis which should be distinguished from the recurrent aphthous stomatitis seen in otherwise healthy individuals. The remarkably high incidence of DLE-like symptoms in heterozygous carriers might be related to the presence of mixed populations of defective and normal phagocytes. The variable expression of skin symptoms may be related to uneven distribution of abnormal and normal phagocytes. Female patients with these clinical symptoms, especially the combination of DLE-like skin lesions and aphthous-like stomatitis, should be suspected of being carriers of chronic granulomatous disease and studies of phagocyte function in vitro should be performed, since the diagnosis of the carrier state is of utmost importance for genetic counselling before pregnancy.
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Abstract
Lupus erythematosus (LE) is a multisystem disease. Genetic predisposition, altered immunity, hormones, drugs, viruses, and ultraviolet light all may play a role in etiology. A wide range of cutaneous lesions occur, and variants such as subacute cutaneous LE, complement-deficient LE, and neonatal LE have recently been emphasized. Management of the LE patient, including appropriate diagnostic studies and therapy relevant to the dermatologist, is discussed in the review.
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MESH Headings
- Antigen-Antibody Complex
- Cicatrix/etiology
- Complement System Proteins/deficiency
- Female
- Humans
- Infant, Newborn
- Infant, Newborn, Diseases/diagnosis
- Lupus Erythematosus, Discoid/diagnosis
- Lupus Erythematosus, Discoid/etiology
- Lupus Erythematosus, Discoid/immunology
- Lupus Erythematosus, Discoid/pathology
- Lupus Erythematosus, Discoid/therapy
- Lupus Erythematosus, Systemic/diagnosis
- Lupus Erythematosus, Systemic/therapy
- Male
- Panniculitis, Nodular Nonsuppurative/diagnosis
- Porphyrias/diagnosis
- Skin/pathology
- Ultraviolet Rays/adverse effects
- Vasculitis/immunology
- Virus Diseases/complications
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41
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Koliadenko VG, Nedoboĭ NP, Ena IM, Bazyka DA. [Disseminated intravascular coagulation in skin diseases]. VESTNIK DERMATOLOGII I VENEROLOGII 1981:30-5. [PMID: 7013343] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/23/2023] Open
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42
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Merrell RW, Mowad JJ. Hypercalcemia and discoid lupus erythematosus-like syndrome associated with renal cell carcinoma. Cutis 1980; 26:402-3. [PMID: 7418440] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
Abstract
Multiple systemic manifestations of renal cell carcinoma have been reported. The first case of a discoid lupus erythematosus-like syndrome and the third reported case of hypercalcemia associated with an elevated serum prostaglandin E2 level in a patient with renal cell carcinoma is presented herein.
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43
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Podymov VK, Gladkikh SP, Myskin VS, Muratov MA. [Pathogenesis of discoid lupus erythematosus]. VESTNIK DERMATOLOGII I VENEROLOGII 1980:12-3. [PMID: 7376710] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/24/2023] Open
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44
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Sönnichsen N, Barthelmes H, Meffert H, Albrecht-Nebe H, Diezel W, Günther W. [Immunological diagnosis of lupus erythematosus]. DERMATOLOGISCHE MONATSCHRIFT 1979; 165:708-20. [PMID: 393545] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
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45
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Domke HF, Ludwigsen E, Thormann J. Discoid lupus erythematosus possibly due to photochemotherapy. ARCHIVES OF DERMATOLOGY 1979; 115:642. [PMID: 443857] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
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46
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Podymov VK. [Biomedical bases of the general theory of the pathogenesis of lupus erythematosus]. VOPROSY REVMATIZMA 1979:45-51. [PMID: 425415] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
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47
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48
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Grupper C, Prunieras M, Eisenmann D, Durepaire R, Bensoussan L. [Photosensitivity and lupus erythematosus]. ANNALES DE MEDECINE INTERNE 1977; 128:63-4. [PMID: 855971] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
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49
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Kerl H. [New viewpoints on the morphology and etiopathogenesis of lupus erythematosus. 1. Micromorphology of the clinical picture. B. Virus-like structures in lupus erythematosus]. ZEITSCHRIFT FUR HAUTKRANKHEITEN 1976; 51:185-93. [PMID: 184615] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
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50
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Quie PG. Pathology of bactericidal power of neutrophils. Semin Hematol 1975; 12:143-60. [PMID: 1118739] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
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