Department of Dermatology, College of Medicine, University of Hanyang, Seoul, Korea.
J Dermatol. 2018 Apr;45(4):436-443. doi: 10.1111/1346-8138.14233. Epub 2018 Feb 9.
An understanding of the differences in clinical manifestations and laboratory abnormalities between subtypes of cutaneous lupus erythematosus (CLE) is still lacking. The purpose of this study was to analyze demographic, clinical and histological features of CLE according to three main presentation subsets: acute (ACLE), subacute (SCLE) and chronic (CCLE). A 10-year retrospective analysis was performed on data from patients who were diagnosed with CLE between March 2005 and September 2015 in a Korean tertiary referral dermatology clinic. We compared demographic data and clinical and histological findings between three different CLE groups. An overall sample of 220 patients with CLE consisted of 67 patients with ACLE, 25 patients with SCLE and 135 patients with CCLE. Patients with CCLE regardless of systemic lupus erythematosus (SLE) presence had lower prevalence of anemia, urinary abnormalities and elevated erythrocyte sedimentation rate. Furthermore, CCLE patients who only had skin lesions showed lower female predominance, lower extracutaneous manifestation, fewer laboratory and immunological abnormalities including low antinuclear antibody titers and the lowest positivity for C3, C4 and anti-dsDNA, anti-Ro, anti-Sm and anti-RNP antibodies, and more prominent perieccrine inflammation and dermal fibrosis in histological findings. Considering distinct cutaneous manifestations of LE, a comprehensive awareness of each CLE subtype is important for achieving a favorable prognosis through appropriate diagnosis and management. This study provides comparative clinical and histological profiles of patients with different CLE subtypes in Korea.
对不同皮肤型红斑狼疮(CLE)亚型的临床表现和实验室异常的理解仍存在不足。本研究旨在根据三种主要表现亚型(急性型 [ACLE]、亚急性型 [SCLE] 和慢性型 [CCLE])分析 CLE 的人口统计学、临床和组织学特征。对 2005 年 3 月至 2015 年 9 月期间在韩国一家三级转诊皮肤科诊所诊断为 CLE 的患者数据进行了 10 年回顾性分析。我们比较了三种不同 CLE 组之间的人口统计学数据以及临床和组织学发现。一个包含 220 名 CLE 患者的总体样本中,有 67 名 ACLE 患者、25 名 SCLE 患者和 135 名 CCLE 患者。无论是否存在系统性红斑狼疮(SLE),CCLE 患者发生贫血、尿液异常和红细胞沉降率升高的比例较低。此外,仅患有皮肤病变的 CCLE 患者中,女性患病率较低、皮肤外表现较少、实验室和免疫学异常较少,包括低抗核抗体滴度和 C3、C4 和抗 dsDNA、抗 Ro、抗 Sm 和抗 RNP 抗体的阳性率最低,以及组织学检查中更明显的毛囊周围炎症和真皮纤维化。鉴于 LE 的不同皮肤表现,全面了解每种 CLE 亚型对于通过适当的诊断和管理实现良好的预后非常重要。本研究提供了韩国不同 CLE 亚型患者的比较临床和组织学特征。