Dermatology · UKMLA & AKT
Cutaneous manifestations of systemic lupus erythematosus
A free high-yield preview for the UKMLA Applied Knowledge Test, covering how to recognise this condition. The full SA Note notes add investigations, management and complications, with practice questions on this topic.
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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