Chronic discoid lupus erythematosus (CDLE)

Last Updated: 2019-08-27

Author(s): Anzengruber, Navarini

Lupus erythematodes integumentalis, lupus erythematodes chronicus discoides, Lupus erythematodes chronicus, diskoider lupus erythematodes (DLE), discoid lupus erythematodes.

Chronic cutaneous form of LE. Most common manifestation of cutaneous LE.

  • Most common cutaneous LE form.
  • The initial manifestation usually occurs between 20-40 years
  • Women are more often affected: 2:1-4:1.
  • More common among Africans.
  • Categorisation
  • Localized form (approx. 80 %)
    • Head
  • Disseminated form (approx. 20 %)
    • Head, trunk and extremity extensor sides.
  • DLE of the oral mucosa
    • Mostly the cheek mucosa is affected, less often the palate.
  • Genetics is very likely to play a role.
  • trigger factors
  • Cold.
  • UV radiation (triggering reproducible in 30-40% of patients by light (UVB)).
    • Solaria can also trigger exacerbation and in rare cases lupus nephritis.

  • Discoids, sharply defined, erythematous plaques with partly follicular hyperkeratoses. Some patients report hyperaesthesia in the area of skin lesions. Dolent "wallpapering nail phenomenon". The skin lesions heal and leave behind atrophic skin.
  • Healing at the capillitium can occur in the context of scarring alopecia. Perioral scarring in the nasal and oral mucosa.
  • S. kutaner Lupus erythematodes.Note
  • ANAs (5% ↑), as a rule.
  • Anti-dsDNA (rare).
  • Ro/SSA (rare).
  • U1-RNP (rare).

Moderate compact ortho- and parahyperkeratosis, follicular hyperkeratosis, acanthosis or atrophy of the epidermis, hydroptic degeneration of the cells of the stratum basal, necrotic/apoptotic keratinocytes in the basal epidermis (colloid bodies), edema in the upper corium, interfacedermatitis, widened PAS-positive basement membrane, periadnexual and perivascular lymphocytic infiltrates.

Die disseminierte Form geht häufiger in einen SLE über als die lokalisierte.

  • S. Cutaneous lupus erythematosus.
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