Dermatology · UKMLA & AKT
Cutaneous manifestations of systemic lupus erythematosus
A free high-yield preview for the UKMLA Applied Knowledge Test. Below are the key points to recognise cutaneous manifestations of systemic lupus erythematosus — the full SA Note notes add investigations, management, complications and 10 practice questions.
Key high-yield points
- Discoid lupus erythematosus (DLE) - well-defined, indurated, erythematous/hyperpigmented plaques with adherent scaling, follicular plugging, and central atrophy; heals with atrophic scarring and dyspigmentation (central hypopigmentation, hyperpigmented rim); predominantly affects face and scalp
- Malar (butterfly) rash - erythematous flush across cheeks and nose bridge, sparing the nasolabial folds; photosensitive, non-scarring
- Subacute cutaneous lupus (SCLE) - widespread photosensitive rash; annular plaques or papulosquamous eruption; V-distribution on neck/upper chest/arms; non-scarring; associated with anti-Ro (SSA) antibodies
- Photosensitivity - present in virtually all subtypes; UV exposure worsens or triggers lesions
- Scarring alopecia - permanent; seen in scalp DLE (follicle destruction is irreversible). Distinct from non-scarring diffuse alopecia of systemic SLE
- Oral ulcers - typically painless, on hard palate or buccal mucosa
- Drug-induced SCLE - caused by thiazide diuretics, terbinafine, calcium channel blockers, proton pump inhibitors; anti-Ro positive; resolves on drug withdrawal
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