Lupus Erythematosus in Pigmented and Black Skin

  • Evelina Buinsauskaité
  • Constantin E. OrfanosEmail author


Lupus erythematosus (LE) is an autoimmune, chronic inflammatory, often multisystem disease, seen in all populations worldwide. It is characterized by a wide spectrum of clinical symptoms and immune serological parameters, with variable evolution and prognosis. The skin is the most frequent site of involvement, showing variable erythematous lesions and overlapping features which make the diagnosis by the physician often difficult, particularly in pigmented or black skin. There are various classifications and different variants and subtypes of the disease with three major forms: The discoid or chronic cutaneous lupus (DLE), the subacute cutaneous lupus (SCLE), and the systemic form of the disease with involvement of the joints or visceral organs (SLE).


  1. 1.
    Findlay GH, Lups JG. The incidence and pathogenesis of chronic discoid lupus erythematosus. An analysis of 191 consecutive cases from the Transvaal. S Afr Med J. 1967;41:694–8.PubMedGoogle Scholar
  2. 2.
    Tebbe B, Orfanos CE. Epidemiology and socioeconomic impact of skin disease in lupus erythematosus. Lupus. 1997;6:96–104.CrossRefPubMedGoogle Scholar
  3. 3.
    Ng PP, Tan SH, Koh ET. Epidemiology of cutaneous lupus erythematosus in a tertiary referral centre in Singapore. Australas J Dermatol. 2000;41:229–33.CrossRefPubMedGoogle Scholar
  4. 4.
    Grönhagen CM, Nyberg F. Cutaneous lupus erythematosus: an update. Indian Dermatol Online J. 2014;5:7–13.CrossRefPubMedPubMedCentralGoogle Scholar
  5. 5.
    Callen JP. Chronic cutaneous lupus erythematosus: clinical, laboratory, therapeutic, and prognostic examination of 62 patients. Arch Dermatol. 1982;118:412–6.CrossRefPubMedGoogle Scholar
  6. 6.
    Deligny C, Clyti E, Sainte Marie D, et al. Incidence of chronic cutaneous lupus erythematosus in French Guiana: a retrospective population-based study. Arthritis Care Res. 2010;62:279–82.CrossRefGoogle Scholar
  7. 7.
    Johnson AE, Gordon C, Palmer RG, et al. The prevalence and incidence of systemic lupus erythematosus in Birmingham, England. Relationship to ethnicity and country of birth. Arthritis Rheum. 1995;38:551–8.CrossRefPubMedGoogle Scholar
  8. 8.
    Ogunbiyi AO, Daramola OO, Alese OO. Prevalence of skin diseases in Ibadan, Nigeria. Int J Dermatol. 2004;43:31–6.CrossRefPubMedGoogle Scholar
  9. 9.
    Cherif F, Mebazaa A, Mokni M, et al. Childhood discoid lupus erythematosus: a Tunisian retrospective study of 16 cases. Pediatr Dermatol. 2003;20:295–8.CrossRefPubMedGoogle Scholar
  10. 10.
    Mahfoudh A, Khaled A, Chtourou O, et al. Chronic lupus erythematosus: 104 Tunisian cases. Tunis Med. 2010;88:742–5.PubMedGoogle Scholar
  11. 11.
    Deligny C, Marie DS, Clyti E, et al. Pure cutaneous lupus erythematosus in a population of African descent in French Guiana: a restrospective population-based description. Lupus. 2012;21:1467–71.CrossRefPubMedGoogle Scholar
  12. 12.
    Graham RR, Ortmann WA, Langefeld CD, et al. Visualizing human leukocyte antigen class II risk haplotypes in human systemic lupus erythematosus. Am J Hum Genet. 2002;71:543–53.CrossRefPubMedPubMedCentralGoogle Scholar
  13. 13.
    Fabbri P, Cardinall C, Giomi B, et al. Cutaneous lupus erythematosus. Orphanet Encyclopedia, October 2004.Google Scholar
  14. 14.
    Boeckler P, Cosnes A, Frances C, et al. Association of cigarette smoking but not alcohol consumption with cutaneous lupus erythematosus. Arch Dermatol. 2009;145:1012–6.CrossRefPubMedGoogle Scholar
  15. 15.
    Wenzel J, Zahn S, Tüting T. Pathogenesis of cutaneous lupus erythematosus: common and different features in distinct subsets. Lupus. 2010;19:1020–8.CrossRefPubMedGoogle Scholar
  16. 16.
    Jacyk WK, Damisah M. Discoid lupus erythematosus in the Nigerians. Br J Dermatol. 1979;100:131–5.CrossRefPubMedGoogle Scholar
  17. 17.
    Verma SM, Okawa J, Propert KJ, et al. The impact of skin damage due to cutaneous lupus on quality of life. Br J Dermatol. 2014;170:315–21.CrossRefPubMedPubMedCentralGoogle Scholar
  18. 18.
    Jacyk WK, Bhana KN. Lupus erythematosus profundus in black South Africans. Int J Dermatol. 2006;45:717–21.CrossRefPubMedGoogle Scholar
  19. 19.
    Nozile W, Adgerson CN, Cohen GF. Cutaneous lupus erythematosus in skin of color. J Drugs Dermatol. 2015;14:343–9.PubMedGoogle Scholar
  20. 20.
    Bertsias G, Cervera R, Boumpas D. Systemic lupus erythematosus: pathogenesis and clinical features. In: EULAR textbook on rheumatic diseases. Geneva, Switzerland: European League against Rheumatism; 2012. p. 476–505.Google Scholar
  21. 21.
    Lee HJ, Sinha AA. Cutaneous lupus erythematosus: understanding of clinical features, genetic basis, and pathobiology of disease guides therapeutic strategies. Autoimmunity. 2006;39:433–44.CrossRefPubMedGoogle Scholar
  22. 22.
    Word AP, Perese F, Tseng LC, et al. 25-OH vitamin D levels in African American and Caucasian/Hispanic cutaneous lupus subjects. Br J Dermatol. 2012;166:372–9.CrossRefPubMedPubMedCentralGoogle Scholar
  23. 23.
    Chang AY, Werth VP. Treatment of cutaneous lupus. Curr Rheumatol Rep. 2011;13:300–7.CrossRefPubMedPubMedCentralGoogle Scholar
  24. 24.
    Jewell ML, McCauliffe DP. Patients with cutaneous lupus erythematosus who smoke are less responsive to antimalarial treatment. J Am Acad Dermatol. 2000;42:983–7.CrossRefPubMedGoogle Scholar
  25. 25.
    Motswaledi MH, Khammissa RA, Wood NH, et al. Discoid lupus erythematosus as it relates to cutaneous squamous cell carcinoma and to photosensitivity. SADJ. 2011;66:340–3.PubMedGoogle Scholar
  26. 26.
    Molomo EM, Bouckaert M, Khammissa RA, et al. Discoid lupus erythematosus-related squamous cell carcinoma of the lip in an HIV-seropositive black male. J Can Res Ther. 2015;11:1036.Google Scholar

Copyright information

© Springer International Publishing AG, part of Springer Nature 2018

Authors and Affiliations

  • Evelina Buinsauskaité
    • 1
  • Constantin E. Orfanos
    • 2
    Email author
  1. 1.DermatovenerologistKaunasLithuania
  2. 2.The Free University of Berlin, Medical School CharitéBerlinGermany

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