Saurit Verónica, Campana Ricardo, Ruiz Lascano Alejandro, Ducasse Cristina, Bertoli Ana, Agüero Santiago, Alvarellos Alejandro, Caeiro Francisco
Departamentos de, Reumatología, Hospital Privado, Córdoba, Argentina.
Medicina (B Aires). 2003;63(4):283-7.
The objective was to analyze the prevalence of mucocutaneous lesions in patients with systemic lupus erythematosus (SLE). During a 3-year period, we analyzed 77 patients with a diagnosis of SLE. The mucocutaneous lesions were classified into specific and non-specific. We defined skin type, sunlight exposure and photoprotection and correlated these lesions with serology and disease activity. Acute specific lesions were found in 67.5% of the patients, subacute lupus in 6.5% and chronic lesions in 26.0%. The most prevalent non-specific lesions were alopecia (59.7%), photosensitivity (57.1%), Raynaud's syndrome (46.7%), oral ulcerations (15.6%) and livedo reticularis (11.7%). Skin type 3 (35%) and exposure to mild ultraviolet radiation (74%) were seen in the majority of the patients. Appropriate sunlight protection was only used by 47% of the patients. When dermatological lesions and serology were compared, we found a significant association between malar rash, photosensitivity, livedo reticularis and alopecia with the presence of anti-Ro and Raynaud's phenomenon in patients with positive anti-Sm. The presence of malar rash, photosensitivity, Raynaud's phenomenon, diffuse alopecia and livedo reticularis was more frequent among patients with active disease. The prevalence of mucocutaneous manifestation in our population was slightly higher than data reported in other series. The presence of malar rash, diffuse alopecia, photosensitivity and livedo reticularis significantly related with the presence of anti-Ro and Raynaud's phenomenon with anti-Sm. All these lesions were more frequently seen in patients with active disease.
目的是分析系统性红斑狼疮(SLE)患者黏膜皮肤病变的患病率。在3年期间,我们分析了77例诊断为SLE的患者。黏膜皮肤病变分为特异性和非特异性。我们定义了皮肤类型、阳光暴露和光防护,并将这些病变与血清学和疾病活动度相关联。67.5%的患者出现急性特异性病变,6.5%为亚急性狼疮,26.0%为慢性病变。最常见的非特异性病变为脱发(59.7%)、光敏性(57.1%)、雷诺综合征(46.7%)、口腔溃疡(15.6%)和网状青斑(11.7%)。大多数患者为3型皮肤(35%)且暴露于轻度紫外线辐射(74%)。只有47%的患者采取了适当的阳光防护措施。比较皮肤病变和血清学时,我们发现抗Ro阳性且抗Sm阳性的患者中,颊部皮疹、光敏性、网状青斑和脱发与抗Ro的存在及雷诺现象之间存在显著关联。在疾病活动期的患者中,颊部皮疹、光敏性、雷诺现象、弥漫性脱发和网状青斑更为常见。我们人群中黏膜皮肤表现的患病率略高于其他系列报道的数据。颊部皮疹、弥漫性脱发、光敏性和网状青斑的存在与抗Ro的存在及抗Sm相关的雷诺现象显著相关。所有这些病变在疾病活动期的患者中更常见。