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红斑狼疮:关于临床、皮肤及治疗方面的考量

Lupus erythematosus: considerations about clinical, cutaneous and therapeutic aspects.

作者信息

Moura Filho Jucélio Pereira, Peixoto Raiza Luna, Martins Lívia Gomes, Melo Sillas Duarte de, Carvalho Ligiana Leite de, Pereira Ana Karine F da Trindade C, Freire Eutilia Andrade Medeiros

机构信息

Paraiba Federal University, João PessoaPB, Brazil, Medical Students Paraiba Federal University (UFPB) - João Pessoa (PB), Brazil.

Paraiba Federal University, Morphology Department, João PessoaPB, Brazil, DDS, PhD in Stomatology - Adjunct Professor at the Morphology Department at Paraiba Federal University (UFPB) - João Pessoa (PB), Brazil.

出版信息

An Bras Dermatol. 2014 Jan-Feb;89(1):118-25. doi: 10.1590/abd1806-4841.20142146.

Abstract

Systemic Lupus Erythematosus is a chronic inflammatory disease with multifactorial etiology. Although clinical manifestations are varied, the skin is an important target-organ, which contributes to the inclusion of skin lesions in 4 out of the 17 new criteria for the diagnosis of the disease, according to the Systemic Lupus International Collaborating Clinics. The cutaneous manifestations of lupus are pleomorphic. Depending on their clinical characteristics, they can be classified into Acute Cutaneous Lupus Erythematosus, Subacute Cutaneous Lupus Erythematosus, Chronic Cutaneous Lupus Erythematosus and Intermittent Cutaneous Lupus Erythematosus. Treatment is based on preventive measures, reversal of inflammation, prevention of damage to target organs and relief of adverse events due to pharmacological therapy. The most commonly used treatment options are topical, systemic and surgical treatment, as well as phototherapy. The correct handling of the cases depends on a careful evaluation of the morphology of the lesions and the patient's general status, always taking into consideration not only the benefits but also the side effects of each therapeutic proposal.

摘要

系统性红斑狼疮是一种病因多因素的慢性炎症性疾病。尽管临床表现多样,但皮肤是一个重要的靶器官,根据系统性红斑狼疮国际协作临床组的标准,皮肤病变被纳入了该疾病诊断的17项新标准中的4项。狼疮的皮肤表现具有多形性。根据其临床特征,可分为急性皮肤型红斑狼疮、亚急性皮肤型红斑狼疮、慢性皮肤型红斑狼疮和间歇性皮肤型红斑狼疮。治疗基于预防措施、炎症逆转、预防靶器官损伤以及缓解药物治疗引起的不良事件。最常用的治疗选择是局部治疗、全身治疗、手术治疗以及光疗。病例的正确处理取决于对病变形态和患者一般状况的仔细评估,始终不仅要考虑每种治疗方案的益处,还要考虑其副作用。

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