Lupus erythematosus tumidus
Alternate names[edit | edit source]
Intermittent cutaneous lupus; Tumid lupus erythematosus
Definition[edit | edit source]
Tumid erythematosus lupus is considered a rare type of chronic cutaneous lupus erythematosus. Cutaneous lupus erythematosus (CLE) can be divided into acute cutaneous lupus, subacute cutaneous lupus, and chronic cutaneous lupus.
Epidemiology[edit | edit source]
It is more frequent in the African American population. The epidemiology of tumid lupus specifically has not been well studied.[1][1].
Cause[edit | edit source]
- However, triggering factors such as ultraviolet (UV) radiation have been implicated in worsening lesions of TLE.
- Its association with autoimmune disease has been controversial; if an autoimmune disease is suspected, an autoimmune workup may be initiated.
Signs and symptoms[edit | edit source]
- Tumid erythematosus lupus is characterized by smooth, non-scarring, pink- to violet-colored pimples (papules) on the skin without any other apparent skin changes, such as scarring.
- Patients with tumid lupus erythematosus usually do not have other symptoms of systemic lupus erythematosus or other types of cutaneous lupus erythematosus.
- The papules appear on sun-exposed areas of the face, upper back, V area of the neck, trunk, and arms, and more rarely on thighs and legs.
- They usually affect equally both sides of the body, but may affect only one side.
- Normally, the papules clear without leaving scars.
Diagnosis[edit | edit source]
- A lesional biopsy should be taken from an active, erythematous plaque. [3][3].
- A punch biopsy (4 mm is recommended on the trunk or 3 mm on cosmetically sensitive areas such as the face) should be performed to include the full thickness of the dermis.
- If the histopathologic findings definitively support a diagnosis of tumid lupus, the patient should be evaluated for systemic disease, despite the weak association with SLE. T
- he evaluation for systemic lupus includes a full history and review of systems, physical examination with special attention taken to lymphadenopathy or arthritis, and laboratory tests (ANA with anti-dsDNA and anti-Sm profiles), urinalysis, complete blood count (CBC) with differential, chemistries, ESR, CRP, complement levels (C3, C4), and antiphospholipid antibodies.
- For a more extensive autoimmune workup, autoantibodies such as SS-A/Ro and SS-B/La, anti-U1RNP, and anti-histone antibody can be drawn.
- A lesional biopsy can be sent for direct immunofluorescence (DIF).
- Phototesting can be beneficial for diagnosing TLE; reproduction of lesions after UVA/UVB irradiation may support a diagnosis of tumid lupus.
Treatment[edit | edit source]
The treatment is very effective in most cases, and may include sun protection, anti-malarials drugs, local corticosteroids, topical tacrolimus and light therapy.
NIH genetic and rare disease info[edit source]
Lupus erythematosus tumidus is a rare disease.
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- ↑ Saleh D, Crane JS. Tumid Lupus Erythematosus. [Updated 2020 Aug 16]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2021 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK482515/
- ↑ Saleh D, Crane JS. Tumid Lupus Erythematosus. [Updated 2020 Aug 16]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2021 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK482515/
- ↑ Saleh D, Crane JS. Tumid Lupus Erythematosus. [Updated 2020 Aug 16]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2021 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK482515/
Saleh D, Crane JS. Tumid Lupus Erythematosus. [Updated 2020 Aug 16]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2021 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK482515/
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