Sticherling M
Hautklinik, Universitätsklinikum Erlangen, Ulmenweg 18, 91054, Erlangen, Deutschland.
Z Rheumatol. 2013 Jun;72(5):429-35. doi: 10.1007/s00393-013-1134-9.
Skin manifestations are frequently observed in lupus erythematosus (LE) and are manifold. Nonspecific and specific symptoms can be differentiated with the latter belonging to the dermatologically well-characterized clinical entities of acute cutaneous, subacute cutaneous, chronic cutaneous as well as intermittent cutaneous LE. These forms are differentially related to systemic LE. Patient history and clinical examinations, laboratory and immunoserological findings as well as organ imaging results determine the time point as well as the intensity of therapy. Apart from cessation of smoking and alcohol consumption as well as stringent UV protection, topical therapy with corticosteroids or calcineurin inhibitors may suffice with limited forms of the disease. In many cases, however, systemic treatment with antimalarial drugs as a basic treatment is mandatory. Several immunosuppressive agents can alternatively be used in conjunction with systemic corticosteroids. Early and effective therapy is important to prevent irreversible scarring of the skin and to avoid internal organ damage.
皮肤表现常见于红斑狼疮（LE），且多种多样。非特异性和特异性症状可加以区分，后者属于急性皮肤型、亚急性皮肤型、慢性皮肤型以及间歇性皮肤型LE等具有明确皮肤学特征的临床类型。这些类型与系统性LE存在不同关联。患者病史、临床检查、实验室及免疫血清学检查结果以及器官影像学结果决定了治疗的时间点和强度。除了戒烟戒酒以及严格的紫外线防护外，对于病情较轻的形式，使用皮质类固醇或钙调神经磷酸酶抑制剂进行局部治疗可能就足够了。然而，在许多情况下，必须使用抗疟药进行全身治疗作为基础治疗。也可选用几种免疫抑制剂与全身性皮质类固醇联合使用。早期有效治疗对于防止皮肤不可逆瘢痕形成以及避免内脏器官损害非常重要。
