Acute cutaneous lupus erythematosus (ACLE)

Last Updated: 2022-03-11

Author(s): Anzengruber F., Navarini A.

ICD11: 4A40.00

ACLE.

Initial form of cutaneous lupus erythematosus.

Typical first manifestation at the age of 20-50 years.

UV exposure.

  • Classic butterfly erythema, may scale somewhat.
  • No scars are found after healing of the butterfly rash, but there may be pigmentary ageing (scars are found after discoid lupus lesions).

  • see cutaneous lupus erythematosus.
  • Note: In ACLE, serological work-up is usually non-specific. SS-A/B and dsDNA antibodies may be positive.

UV-exposed areas, especially face (cheeks, eminence-based one sees recesses of the nasolabial folds, though not always). May also affect trunk and extremities.

see cutaneous lupus erythematosus.

  • see cutaneous lupus erythematosus.

Avoid common mistakes:

  • History should always include photosensitivity.
  • Medication history to rule out "drug-induced" lupus erythematosus.
  • Family and self history for autoimmune disease.
  • Avoid a purely superficial biopsy.
  • Therapy should not be changed until preventive measures to avoid possible trigger factors have been exhausted and sunscreen with a high sun protection factor is applied daily!

  1. Walling HW, Sontheimer RD. Cutaneous lupus erythematosus: issues in diagnosis and treatment. Am J Clin Dermatol 2009;10:365-81.
  2. Okon LG, Werth VP. Cutaneous lupus erythematosus: diagnosis and treatment. Best Pract Res Clin Rheumatol 2013;27:391-404.
  3. Kuhn, A. (2016). S1-Leitlinie: Kutaner Lupus Erythematodes. Awmf.org. Retrieved 30 May 2016, from http://www.awmf.org/leitlinien/detail/ll/013-060.html