Victoria Werth

Are You Confident of the Diagnosis? Cutaneous lupus mucinosis (CLM), or papulonodular mucinosis, is a rare variant of cutaneous lupus erythematosus (CLE) characterized by an abundance of dermal mucin resulting in papular lesions. It occurs in approximately 1.5% of patients with lupus erythematosus. Secondary mucin deposition can be seen, usually histologically, in more classic lupus…

Are You Confident of the Diagnosis? What you should be alert for in the history Lupus erythematosus tumidus (LET) is considered a form of chronic cutaneous lupus erythematosus (CLE). With LET, as with other chronic cutaneous lupus diseases, the prevalence of lupus-related autoantibodies and development of systemic lupus erythematosus (SLE) is low. Overall, LET is…

Are You Confident of the Diagnosis? Systemic lupus erythematosus (SLE) is a diverse autoimmune disease that can affect many organ systems and has variable clinical and immunologic manifestations. Cutaneous manifestations is the presenting symptom in nearly a quarter of patients with SLE. There are lupus erythematosus specific and nonspecific cutaneous skin lesions. Nonspecific skin lesions…

Are You Confident of the Diagnosis? Characteristic findings on physical examination Lupus erythematosus panniculitis (LEP) is characterized by chronic and recurrent subcutaneous inflammatory lesions and is considered a form of chronic cutaneous lupus erythematosus (CLE). Clinically, LEP appears as erythematous, deeply indurated, tender plaques and nodules. The overlying epidermis is typically normal, but over time…

Are You Confident of the Diagnosis? Subacute cutaneous lupus erythematosus (SCLE) is a clinically distinct form of CLE that presents as a highly photosensitive annular-polycyclic or papulosquamous eruption distributed symmetrically on sun-exposed areas (Figure 1). The upper back, chest, shoulders and extensor arms are frequent sites. Lesions below the waist are uncommon. Unlike discoid lupus…

Are You Confident of the Diagnosis? Chilblain lupus is a rare type of chronic cutaneous lupus erythematosus (CLE). It is characterized by red or violaceous papules and plaques located on acral areas (Figure 1). Cold temperatures, particularly moist cold climates, precipitate the lesion. Mild pain, pruritus and/or hyperhidrosis may be associated with chilblains. The lesions…

Are You Confident of the Diagnosis? What you should be alert for in the history Rowell’s syndrome is a rare entity that was initially characterized by Rowell in 1963 as the coexistence of discoid lupus erythematosus (DLE) and erythema multiforme (EM). The initial cohort of patients also had positive ANA, positive rheumatoid factor and precipitation…

Are You Confident of the Diagnosis? Discoid lupus erythematosus (DLE) is a form of chronic cutaneous lupus erythematosus (CCLE). A diagnosis of discoid lupus erythematosus can be made with the characteristic clinical appearance and location of cutaneous lesions together with histopathologic confirmation. It is a photosensitive dermatosis, but there may not be a clear temporal…