Lupus erythematosus

Lupus erythematosus (LE) is a chronic, multi-systemic autoimmune disease that causes the body's immune system to mistakenly attack healthy cells and tissues. It encompasses a range of clinical entities, the most common forms being systemic lupus erythematosus (SLE) and cutaneous lupus erythematosus (CLE).

Symptoms of SLE

Classification

• Lupus erythematosus can be classified into several types, each with unique clinical characteristics:
• Systemic Lupus Erythematosus (SLE): This is the most common and severe form of LE, affecting multiple organ systems in the body.
• Cutaneous Lupus Erythematosus (CLE): This form predominantly affects the skin, with three main subtypes: acute, subacute, and chronic.
• Drug-induced Lupus Erythematosus (DILE): This is a drug-induced autoimmune condition that typically resolves once the causative drug is discontinued.
• Neonatal Lupus Erythematosus (NLE): This is a rare condition affecting newborns, caused by the transplacental passage of maternal autoantibodies.

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Lupus erythematosus

Pathophysiology

Although the precise cause of LE is unknown, it's considered a multifactorial disease involving genetic, hormonal, environmental, and immunological factors. At the cellular level, it's characterized by the production of a broad array of autoantibodies, most notably antinuclear antibodies (ANA), leading to immune complex formation and inflammation.

Clinical Manifestations

Clinical features of LE can vary significantly between individuals, making it a challenging condition to diagnose. Common symptoms include fatigue, joint pain, and skin rashes — particularly the classic "butterfly rash" over the cheeks and bridge of the nose. More severe manifestations can involve the heart, lungs, kidneys, and nervous system.

Diagnosis

Diagnosis of LE involves a combination of clinical findings and laboratory tests. These may include complete blood count (CBC), urinalysis, and autoantibody tests such as ANA, anti-dsDNA, anti-Sm, and antiphospholipid antibodies. Diagnostic criteria have been developed by the American College of Rheumatology (ACR) and the Systemic Lupus International Collaborating Clinics (SLICC) to assist in the diagnosis of SLE.

Treatment

Management of LE is tailored to the individual's symptoms and organ involvement. Non-steroidal anti-inflammatory drugs (NSAIDs) and antimalarials like hydroxychloroquine are often used to manage mild disease. In moderate to severe disease, corticosteroids and immunosuppressive agents may be required.

Prognosis

The prognosis of LE depends on various factors, including the severity of disease, organs involved, and the individual's response to treatment. With appropriate treatment and management of symptoms, many individuals with LE can lead full and active lives.

See Also

• Autoimmune diseases
• Systemic Lupus Erythematosus
• Cutaneous Lupus Erythematosus
• Drug-induced Lupus Erythematosus
• Neonatal Lupus Erythematosus

References

• D'Cruz DP, Khamashta MA, Hughes GR. (2007). Systemic lupus erythematosus. The Lancet, 369(9561), 587-596.
• Petri M, Orbai AM, Alarcón GS, et al. (2012). Derivation and validation of the Systemic Lupus International Collaborating Clinics classification criteria for systemic lupus

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