Baylor Institute for Immunology Research, Dallas, TX, USA.
Lupus. 2010 Aug;19(9):1050-70. doi: 10.1177/0961203310370048.
The skin is the second most frequently affected organ system in lupus erythematosus. Although only very rarely life threatening--an example is lupus erythematosus-associated toxic epidermal necrolysis--skin disease contributes disproportionally to disease burden in terms of personal and psychosocial wellbeing, vocational disability, and hence in medical and social costs. Since several manifestations are closely associated with the presence and activity of systemic lupus erythematosus, prompt and accurate diagnosis of cutaneous lupus erythematosus is essential. This review aims to cover common, rare, and atypical manifestations of lupus erythematosus-associated skin disease with a detailed discussion of histopathological correlates. Cutaneous lupus erythematosus covers a wide morphological spectrum well beyond acute, subacute and chronic cutaneous lupus erythematosus, which are commonly classified as lupus-specific skin disease. Other uncommon or less well-known manifestations include lupus erythematosus tumidus, lupus profundus, chilblain lupus, mucosal lupus erythematosus, and bullous lupus erythematosus. Vascular manifestations include leukocytoclastic and urticarial vasculitis, livedoid vasculopathy and livedo reticularis/ racemosa. Finally, we discuss rare presentations such as lupus erythematosus-related erythema exsudativum multiforme (Rowell syndrome), Kikuchi-Fujimoto disease, extravascular necrotizing palisaded granulomatous dermatitis (Winkelmann granuloma), and neutrophilic urticarial dermatosis.
皮肤是红斑狼疮中第二常受影响的器官系统。尽管它很少会威胁生命——例如红斑狼疮相关的中毒性表皮坏死松解症——但就个人和社会心理健康、职业残疾，以及医疗和社会成本而言，皮肤疾病对疾病负担的影响不成比例。由于几种表现与系统性红斑狼疮的存在和活动密切相关，因此及时准确地诊断红斑狼疮性皮肤病至关重要。本篇综述旨在涵盖与狼疮相关的皮肤疾病的常见、罕见和非典型表现，并详细讨论其组织病理学相关性。红斑狼疮性皮肤病涵盖了广泛的形态学谱，远远超出了急性、亚急性和慢性红斑狼疮性皮肤病，这些通常被归类为狼疮特异性皮肤病。其他不常见或不太为人知的表现包括红斑狼疮性肿胀、深部红斑狼疮、冻疮样狼疮、黏膜红斑狼疮和大疱性红斑狼疮。血管表现包括白细胞碎裂性和荨麻疹性血管炎、线状血管病和网状青斑/Racemosa。最后，我们讨论了一些罕见的表现，如红斑狼疮相关性多形性渗出性红斑（Rowell 综合征）、Kikuchi-Fujimoto 病、血管外坏死性栅栏状肉芽肿性皮炎（Winkelmann 肉芽肿）和中性粒细胞性荨麻疹性皮炎。
