Subacute Cutaneous Lupus Erythematosus

Abstract

Subacute cutaneous lupus erythematosus (SCLE) represents a relatively distinct and homogeneous subset of lupus erythematosus (LE). It is identified by chronic and recurrent development of characteristic erythematous, nonscarring and mostly photosensitive skin lesions, associated with particular clinical, immunological and genetic features. SCLE-specific cutaneous lesions include the papulosquamous-psoriasiform eruption and the annular-polycyclic erythema. They are found in approximately 10% of total LE patients and affect predominantly white women of all ages. In addition, a significant proportion of patients with SCLE eruptions may have Sjogren’s syndrome (SS). Extracutaneous manifestations are usually, but not always, mild. Serum autoantibodies to RoSS-A cellular antigen that occur in approximately 25%–30% of total systemic lupus erythematosus (SLE) patients, are more common in SCLE (found in 60%–70%) suggesting that SCLE comprises roughly 30%–40% of all antiRoSS-A positive patients. Approximately 50% of antiRoSS-A positive SCLE patients display also serum antiLaSS-B antibodies. Associations of SCLE with HLA-DR₃, HLA-DR₂ as well as C₄ null alleles have also been reported. Finally, besides SLE and SS, a number of other systemic diseases that have been described to precede, to coincide with or to follow the onset of SCLE include rheumatoid arthritis, porphyria cutanea tarda, Sweet’s syndrome, malabsorption, gluten-sensitive enteropathy, hereditary angioedema and various malignancies, including malignant melanoma, lung, breast and gastric cancer.