Koritala Thoyaja, Grubbs Hailey, Crane Jonathan S.
Mayo Clinic
Lincoln Memorial Un- DeBusk COM
Cutaneous lupus erythematosus (CLE) can present in three forms: acute cutaneous lupus erythematosus (ACLE), subacute cutaneous lupus erythematosus (SCLE), and chronic cutaneous lupus erythematosus (CCLE). CCLE can be further be subdivided into chronic subtypes consisting of tumid lupus erythematosus (TLE), discoid lupus erythematosus (DLE), chilblain lupus erythematosus, and lupus panniculitis. Although these forms possess morphologies and histological features distinct from one another, more than one form can co-exist in the same patient. Although tumid lupus erythematosus (TLE) is currently considered to be a subtype of cutaneous lupus erythematosus (CLE), TLE differs from the other subtypes of cutaneous lupus erythematosus in that an association with systemic lupus erythematosus (SLE) is rare. Because of this weak association with SLE and a relative lack of serologic abnormalities in patients with TLE, some consider TLE to be an entity separate from lupus. It has also been postulated that TLE is in the same spectrum as lymphocytic infiltrate of Jessner and reticular erythematous mucinosis (REM) due to similar findings on histology. Tumid lupus erythematosus (TLE) typically presents as annular, indurated, erythematous, edematous papules and plaques without epidermal involvement. If any of these features are recognized, and epidermal involvement is likely, a diagnosis of DLE should be suspected. Typical locations of TLE are the face and trunk, and lesions respond well to photoprotection, topical corticosteroids, and antimalarials.
皮肤红斑狼疮（CLE）可表现为三种形式：急性皮肤红斑狼疮（ACLE）、亚急性皮肤红斑狼疮（SCLE）和慢性皮肤红斑狼疮（CCLE）。CCLE可进一步细分为慢性亚型，包括肿胀性红斑狼疮（TLE）、盘状红斑狼疮（DLE）、冻疮样红斑狼疮和狼疮性脂膜炎。尽管这些形式具有彼此不同的形态和组织学特征，但不止一种形式可同时存在于同一患者中。虽然肿胀性红斑狼疮（TLE）目前被认为是皮肤红斑狼疮（CLE）的一种亚型，但TLE与皮肤红斑狼疮的其他亚型不同，因为它与系统性红斑狼疮（SLE）的关联很少见。由于TLE患者与SLE的这种弱关联以及相对缺乏血清学异常，一些人认为TLE是一种与狼疮不同的实体。也有人推测，由于组织学上的相似发现，TLE与Jessner淋巴细胞浸润和网状红斑性粘蛋白病（REM）属于同一谱系。肿胀性红斑狼疮（TLE）通常表现为环形、硬结性、红斑性、水肿性丘疹和斑块，不累及表皮。如果识别出这些特征中的任何一个，且可能累及表皮，则应怀疑为DLE。TLE的典型部位是面部和躯干，病变对光防护、外用糖皮质激素和抗疟药反应良好。
