Cutaneous manifestations of systemic lupus erythematosus

Lupus erythematosus (LE) is a heterogeneous connective tissue disease associated with polyclonal B-cell activation and is believed to result from the interplay of genetic, environmental and hormonal factors. The spectrum of disease ranges from limited cutaneous involvement to devastating systemic disease. Skin is the second most common organ involved with varying morbidity. In about 80% of cases skin rash is present at some stages of disease process and in 25% cases it is the presenting sign. Four out eleven classification criteria for systemic lupus erythematosus (ACR criteria1982) comprise cutaneous manifestations of the disease. Cutaneous manifestations in LE may be lupus-specific or lupus non-specific but related to the disease process. Cutaneous involvement is responsible for morbidity, which is caused by scarring, dyspigmentation, etc. and types of cutaneous involvement may serve as a good barometer of the pattern of underlying systemic activity. Acute cutaneous LE (lupus-specific) has a strong association with systemic disease and non-specific skin lesions always indicate disease activity for which patients present to rheumatologists and internists.