Department of Dermatology, Hospital Clínic, University of Barcelona, Villarroel 170, 08036 Barcelona, Catalonia, Spain.
Br J Dermatol. 2010 Jan;162(1):91-101. doi: 10.1111/j.1365-2133.2009.09472.x. Epub 2009 Sep 28.
Background Lupus erythematosus (LE) is a chronic, autoimmune disease resulting from an interaction of genetic, environmental and hormonal factors and characterized by a spectrum of clinical forms with variable evolution from a localized cutaneous form to a life-threatening systemic form. Objective To analyse and compare the prevalence and characteristics of the main clinical and immunological manifestations of subacute cutaneous LE (SCLE) and chronic CLE (CCLE). Methods A total of 270 patients with CLE (112 patients with SCLE and 158 patients with CCLE) were studied retrospectively. The clinical and serological characteristics of all the patients were collected in a chart review. Results The patients with SCLE had a higher prevalence of annular and papulosquamous lesions, Raynaud phenomenon, mucous membrane ulcers, malar rashes, photosensitivity, vasculitis and a lower frequency of discoid lesions and alopecia compared with patients with CCLE. Patients with SCLE had a higher prevalence of arthralgias (P < 0.001), xerophthalmia (P = 0.045), arthritis (P < 0.001), nephropathy (P = 0.003) and systemic LE (SLE) (P < 0.001) compared with patients with CCLE. Patients with SCLE also had a higher frequency of laboratory and serological abnormalities than patients with CCLE. Generalized discoid LE (DLE) was associated with a higher prevalence of photosensitivity (P < 0.001), panniculitis (P = 0.009) and SLE (P = 0.003) than localized DLE. In patients with SCLE and those with CCLE, photosensitivity, arthralgias, arthritis, nephropathy and xerophthalmia were associated with SLE. In patients with SCLE, significant correlations existed between clinical and immunological data. Conclusions In our series, differences in the expression of CCLE and SCLE were found with respect to the distribution and type of lesions, systemic features and immunological findings.
红斑狼疮（LE）是一种慢性自身免疫性疾病，由遗传、环境和激素因素相互作用引起，其特征是临床表现多样，从局限性皮肤表现到危及生命的系统性表现均有涉及。目的：分析并比较亚急性皮肤型红斑狼疮（SCLE）和慢性皮肤型红斑狼疮（CCLE）的主要临床和免疫学表现的患病率和特征。方法：回顾性分析 270 例 LE 患者（112 例 SCLE 患者和 158 例 CCLE 患者）。通过病历回顾收集所有患者的临床和血清学特征。结果：与 CCLE 患者相比，SCLE 患者的环状和丘疹鳞屑性皮损、雷诺现象、黏膜溃疡、蝶形皮疹、光过敏、血管炎的患病率更高，盘状皮损和脱发的患病率更低。与 CCLE 患者相比，SCLE 患者的关节痛（P < 0.001）、干眼症（P = 0.045）、关节炎（P < 0.001）、肾病（P = 0.003）和系统性红斑狼疮（SLE）（P < 0.001）的患病率更高。SCLE 患者的实验室和血清学异常的频率也高于 CCLE 患者。广泛性盘状 LE（DLE）与光过敏（P < 0.001）、脂膜炎（P = 0.009）和 SLE（P = 0.003）的患病率较高有关，而局限性 DLE 则不然。在 SCLE 患者和 CCLE 患者中，光过敏、关节痛、关节炎、肾病和干眼症与 SLE 有关。在 SCLE 患者中，临床和免疫学数据之间存在显著相关性。结论：在本研究中，我们发现 CCLE 和 SCLE 在皮损分布和类型、全身表现和免疫学发现等方面存在差异。
