Lupus Erythematosus

lupus erythematosus

[′lü·pəs ‚er·ə‚thē·mə′tō·səs] (medicine) An acute or subacute febrile collagen disease characterized by a butterfly-shaped rash over the cheeks and perilingual erythema.

Lupus Erythematosus

a disease occurring in two distinct forms: (1) discoid lupus erythematosus, a chronic disease of the skin that usually does not alter the patient’s general condition (the disease was described in detail in 1851 by the French physician P. Cazenave), and (2) systemic lupus erythematosus (first identified under the name acute lupus erythematosus in 1872 by the Austrian physician M. Kaposi), a serious disease affecting many internal organs with systemic involvement of connective tissue and blood vessels. It belongs to the group classified as collagen diseases. Both forms are related inasmuch as discoid lupus erythematosus occasionally progresses into the systemic form. The etiology of the disease has not been conclusively determined.

Discoid lupus erythematosus is manifested by skin lesions in the form of red patches covered with whitish-gray scales. These patches gradually enlarge, and the skin in the center soon thins and a small scar forms. It occurs most frequently on the face in a symmetrical fashion, extending from the bridge of the nose to the cheeks in a butterfly-like shape. The auricles, scalp, chest, and, less commonly, the extremities are also affected. The disease persists for years and decades, worsening in the spring and summer.

Systemic lupus erythematosus is characterized by great variation of symptoms from patient to patient. All patients suffer from joint problems, such as intermittent or persistent pain, swelling and reddening, and, less commonly, deformation of the small joints of the hands. The muscles and tendons are also likely to be involved, and peculiar transient contractures appear. A variety of skin rashes is often encountered. The lesion on the bridge of the nose spreading to the cheeks, the butterfly-like rash, is characteristic. Specific lesions may develop on the mucous membranes of the oral cavity and on the lips. Many patients suffer loss of hair, dry skin, and brittle nails. Involvement of the serous membranes is a part of the characteristic triad of dermatitis, polyarthritis, and polyserositis. Lupus erythematosus may also cause myocarditis and endocarditis, various inflammatory processes of the lung (pneumonitis), nephritis, and lesions of the nervous system. (At the beginning there may be irritability or depression, and insomnia; later encephalitis, myelitis, or polyneuritis develop.) Sometimes the gastrointestinal system is involved, including liver and spleen enlargement. The lymphatic system may be impaired by the disease. Anemia, leukopenia, and thrombocytopenia develop. The eyes are affected. A typical laboratory finding of lupus erythematosus is the presence of special cells (the so-called LE cells) and antinuclear antibodies in the blood. The course of systemic lupus erythematosus may be acute, subacute, or chronic, depending on the severity of the initial phase and the general course of the disease.

Treatment includes long-term administration of synthetic antimalarial agents (Delagil, chloroquinum, Resochin), which have an anti-inflammatory and desensitizing effect, and vitamins B₂, B₁₂, and nicotinic acid. Discoid lupus erythematosus is treated by gold compounds and local application of ointments (prednisolone, Locacorten, Synalar, and zinc ointment for protection against the sun). Systemic lupus erythematosus is treated by a combination of cortico-sterone hormones (prednisolone, triamcinolone, dexamethasone) and antimalarial agents and antibiotics (to treat or prevent infection) and by general supportive measures.

REFERENCES

Arutiunov, V. Ia. Krasnaia volchanka. Moscow, 1961. (Bibliography.)
Nesterov, A. I., and Ia. A. Sigidin. Klinika kollagenovykh boleznei, 2nd ed. Moscow, 1966. (Bibliography.)
Tareev, E. M. Kollagenozy. Moscow, 1965. (Bibliography.)

V. A. NASONOVA

lupus erythematosus

lupus

[loo´pus] a name originally given to a destructive type of skin lesion, implying a local degeneration rather than systemic involvement. Although the term is frequently used alone to designate lupus vulgaris and sometimes lupus erythematosus, without a modifier it has no meaning. The Latin word lupus means wolf; erythematosus refers to redness. The name lupus erythematosus has been used since the 13th century because physicians thought the shape and color of the skin lesions resembled the bite of a wolf. Currently, there are at least two recognized manifestations of the disease: discoid lupus erythematosus and systemic lupus erythematosus.chilblain lupus erythematosus a form of discoid lupus erythematosus aggravated by cold, initially resembling chilblains, in which the lesions consist of reddened infiltrated patches on the exposed areas of the body, especially the finger knuckles.cutaneous lupus erythematosus one of the two main types of lupus erythematosus; it may involve only the skin or may precede involvement of other body systems. It may be chronic (discoid lupus erythematosus); subacute (systemic lupus erythematosus); or acute (characterized by an acute edematous, erythematous eruption, often with systemic exacerbations). The acute form may be the presenting symptom of systemic lupus erythematosus, such as after sun exposure.discoid lupus erythematosus (DLE) a superficial inflammation of the skin, marked by red macules up to 3 to 4 cm in width, and covered with scanty adherent scales, which extend into spreading follicles that fall off and leave scars. The lesions typically form a butterfly pattern over the bridge of the nose and cheeks, but other areas may be involved, notably the scalp and other areas that are exposed to light.drug-induced lupus a syndrome closely resembling systemic lupus erythematosus, precipitated by prolonged use of certain drugs, most commonly hydralazine, isoniazid, various anticonvulsants, and procainamide.lupus erythemato´sus (LE) a group of connective tissue disorders primarily affecting women aged 20 to 40, comprising a spectrum of clinical forms in which cutaneous disease may occur with or without systemic involvement.lupus per´nio 1. soft, purplish skin lesions on the cheeks, forehead, nose, ears, and digits, frequently associated with bone cysts, which may be the first manifestation of sarcoidosis or occur in the chronic stage of the disease.2. chilblain lupus erythematosus.systemic lupus erythematosus (SLE) a chronic inflammatory disease, usually febrile and characterized by injury to the skin, joints, kidneys, nervous system, and mucous membranes. It can, however, affect any organ of the body and usually has periods of remissions and exacerbations. (See plate in Dermatology Atlas.)
It was once thought that this was a fairly rare disease, but improved immunologic testing procedures have shown that it is not. It is primarily a disease of women, occurring five to ten times more often in females than in males. Although the peak incidence is between 30 and 40 years of age, the condition has also been diagnosed in the very young and the very old.
SLE is the classic prototype of autoimmune disease of connective tissue. Its etiology is unknown, but the high level of autoantibodies in persons with the condition indicates a defect in the regulatory mechanisms that sustain self-tolerance and prevent the body from attacking its own cells, cell constituents, and proteins. Patients with SLE can have a wide variety of autoantibodies against nuclear and cytoplasmic cellular components. The presence of high levels of antinuclear antibody (ANA) in SLE patients with glomerulonephritis indicates a pathogenic role for that antibody. The antibodies are directed against deoxyribonucleoprotein, DNA, histone, and a soluble non–nucleic acid molecule called Sm antigen.
Factors that appear to contribute to the development of SLE include exposure to sunlight or ultraviolet radiation from sunlamps, a genetic predisposition to the disease, certain drugs, viral infections, and hormonal influences.
Clinical manifestations of SLE are confusingly diverse owing to the involvement of connective tissue throughout the body. Typically, the patient seeks medical help for relief of fever, weight loss, joint pain, the characteristic butterfly rash, pleural effusion and pleuritic pain, and nephritis. The detection of ANA by microscopic immunofluorescence is supportive evidence for the presence of SLE.
Either glomerulonephritis, which is usually mild, or cardiovascular manifestations such as myocarditis, endocarditis, or pericarditis, are found in about half the patients with SLE. Pulmonary disease, especially pleurisy, is also relatively common, as are gastrointestinal disturbances and lymph node involvement. Organic neurologic disturbances produce behavioral aberrations and frank psychosis in some patients; in a few others, there are peripheral neuropathies, motor weakness, and diplopia.
Supportive measures are used to prevent or minimize acute relapses and exacerbations of symptoms. The patient is instructed to avoid exposure to sunlight and ultraviolet radiation from other sources, blood transfusions, penicillin, and the sulfonamides. Active disease is treated with topical steroids, nonsteroidal antiinflammatory drugs for fever and joint pain, corticosteroids, and immunosuppressants. The goal of drug therapy is suppression of the immune system. Treatment of specific manifestations of SLE is aimed at prevention of complications. Physical therapy may be required to alleviate muscle weakness and prevent orthopedic deformities.lupus vulga´ris the most common and severe form of tuberculosis of the skin, most often affecting the face, with formation of reddish brown patches of nodules in the corium, which progressively spread peripherally with central atrophy, causing ulceration and scarring and destruction of cartilage in involved sites.

lu·pus er·y·the·ma·to·sus (LE, L.E.),

Avoid the misspelling lupus erythematosis.An illness that may be chronic (characterized by skin lesions alone), subacute (characterized by recurring superficial nonscarring skin lesions that are more disseminated and present more acute features both clinically and histologically than those seen in the chronic discoid phase), or systemic or disseminated (in which antinuclear antibodies are present and in which there is almost always involvement of vital structures).
See also: discoid lupus erythematosus, systemic lupus erythematosus.

lupus erythematosus

(ĕr′ə-thē′mə-tō′səs, -thĕm′ə-)n.1. See systemic lupus erythematosus.2. Any of several other autoimmune disorders typically characterized by reddish, scaly lesions on the skin, especially:a. A chronic cutaneous form characterized by patchy lesions that form especially on the head and neck, with accompanying scarring and pigmentation changes; discoid lupus erythematosus.b. A form caused by exposure to a drug and resolving with discontinuance of the drug, characterized by signs and symptoms similar to those of systemic lupus erythematosus; drug-induced lupus erythematosus.

lupus erythematosus

(1) Discoid lupus erythematosus.
(2) Systemic lupus erythematosus.

lu·pus er·y·the·ma·to·sus

(LE) (lū'pŭs ĕr-i'thĕ-mă-tō'sŭs) An illness that may be characterized by skin lesions alone or systemic (disseminated) with antinuclear antibodies present and usually involvement of vital structures.
See also: discoid lupus erythematosus, systemic lupus erythematosus

lupus erythematosus

A general inflammatory disease of CONNECTIVE TISSUE caused by a disturbance of the immune mechanisms with AUTOIMMUNE processes and the formation of IMMUNE COMPLEXES. It may be induced by drugs. The disease takes two forms—chronic discoid lupus erythematosus (DLE) and the more serious, and sometimes life-threatening, form, systemic lupus erythematosus (SLE). DLE features red, raised bumps in the skin, usually on the face and scalp and often a ‘butterfly’ rash across the bridge of the nose and hair loss (ALOPECIA). SLE can involve the joints and tendons, causing ARTHRITIS and sometimes deformities, and the heart, lungs, kidneys, liver and nervous system may be damaged. Lupus erythematosus is treated with steroid drugs and sometimes other immunosuppressive drugs.

Lupus erythematosus

A chronic inflammatory disease in which inappropriate immune system reactions cause abnormalities in the blood vessels and connective tissue.Mentioned in: Abortion, Therapeutic, Alopecia, Diuretics, Dysfunctional Uterine Bleeding

Leloir,

Henri Camille, French physician, 1855-1896. Leloir disease - Synonym(s): lupus erythematosus

lu·pus er·y·the·ma·to·sus

Patient discussion about lupus erythematosus

Q. What is Lupus? My best friend has been diagnosed with Lupus. What is it? Is it contagious? A. No, lupus is not contagious. It cannot be passed from one person to another. Lupus is an autoimmune disease, the cause of which is still unknown.

Q. how long do u live with lupus? why do we get lupus? why was i hit with it along with all my other medical problems? i dont understand why..A. well i've had it now for 1 yr and i'm still going

Q. Is a rash a symptom of lupus? My Sister has lupus for several years now. I recently developed a rash on my face. Is this a symptom of lupus? Could I have also been infected with this disease?A. Lupus has not been proven to be hereditary. Therefore, the fact your sister has lupus shouldn't cause you to beleive you too will develop it. Also a rash is not enough to diagnose lupus. Physicians have to gather information from a variety of sources: past medical history, lab tests and current symptoms. They use a list of 11 criteria to help diagnose SLE. A person needs to satisfy at least 4 out of the 11 criteria before the diagnosis can be pinpointed. Some criteria, such as a biopsy diagnosis of kidney lupus, can carry more weight.

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lupus erythematosus

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lupus erythematosus

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Lupus Erythematosus

lupus erythematosus

Lupus Erythematosus

REFERENCES

lupus erythematosus

lupus

lu·pus er·y·the·ma·to·sus (LE, L.E.),

lupus erythematosus

lupus erythematosus

lu·pus er·y·the·ma·to·sus

lupus erythematosus

Lupus erythematosus

Leloir,

lu·pus er·y·the·ma·to·sus

Patient discussion about lupus erythematosus

lupus erythematosus

Synonyms for lupus erythematosus

noun a chronic inflammatory collagen disease affecting connective tissue (skin or joints)

Synonyms

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