ACLE Study Qs

There are more patients with cutaneous LE without systemic lupus erythematosus (SLE) than patients with SLE according to population-based studies

True

Which of the following is NOT considered an environmental factor in the pathogenesis of cutaneous LE?

a) Ultraviolet radiation (UVR)

b) Medications

c) Cigarette smoking

d) Genetic predisposition

Genetic predisposition

lichenoid tissue reaction is a feature of most subsets of cutaneous LE?

True

Who first used the term 'lupus erythematosus'?

Cazenave

Which of the following is NOT a major form of cutaneous LE according to the Gilliam classification schema?

a) Acute cutaneous LE (ACLE)

b) Subacute cutaneous LE (SCLE)

c) Chronic cutaneous LE (CCLE)

d) Intermittent cutaneous LE

Intermittent cutaneous LE

patients with discoid LE (DLE) lesions have a higher likelihood of progressing to SLE

False

What is a typical characteristic of SCLE lesions?

Lesions may have an annular configuration with raised borders and central clearing.

the malar rash of ACLE typically spares the nasolabial folds?

True

Which autoantibody is NOT specifically associated with SLE?

a) Anti-dsDNA

b) Anti-Sm

c) Anti-SSA/Ro

d) Anti-RNP

Anti-RNP

What is a characteristic histologic finding of discoid LE lesions?

a) Prominent dermal mucin deposition

b) Periadnexal inflammation and follicular plugging

c) Subcutaneous fat inflammation

d) Superficial lymphocytic infiltrate.

Periadnexal inflammation and follicular plugging.

a positive ANA test (titer ≥1:80) is an entry criterion according to the 2019 EULAR/ACR classification criteria for SLE

True

How many points are given for subacute or discoid lupus if observed by a clinician according to the 2019 EULAR/ACR classification?

a) 2 points

b) 3 points

c) 4 points

d) 6 points

4 points

Drug-induced SLE commonly presents with nephritis and CNS disease

False

According to the SLICC classification system for SLE, how many of 17 criteria must be met for a diagnosis?

a) 2

b) 3

c) 4

d) 5

4

What is a typical feature of ACLE?

a) Chronic, relapsing course.

b) Annular configuration with raised borders.

c) "Butterfly rash"

d) Significant scarring

'Butterfly rash'.

Which condition is typically associated with anti-SSA/Ro autoantibodies? ◦

a) Acute cutaneous LE (ACLE)

b) Discoid LE (DLE)

c) Lupus panniculitis (LEP)

d) Subacute cutaneous LE (SCLE)

Subacute cutaneous LE (SCLE)

Patients with SLE have more prominent nail-fold capillary abnormalities than patients with systemic sclerosis

True

Which of the following is NOT a typical non-specific cutaneous finding in LE?

a) Raynaud phenomenon

b) Livedo reticularis

c) Palmar erythema

d) Gottron's papules

Gottron's papules

What is the primary location of inflammatory infiltrates in LE tumidus?

a) Superficial dermis

b) Superficial and deep dermis perivascular and periadnexal

c) Subcutaneous fat

d) Epidermis

Superficial and deep dermis perivascular and periadnexal.

In the past, "ANA-negative SLE" was more common, especially in patients with anti-SSA/Ro antibodies, but is now rare due to the use of human HEp-2 cells in ANA assays

True

Anti-histone antibodies are a serologic marker of drug-induced ANA and drug-induced SLE, and can also be present in patients with idiopathic SLE

True

Phototherapy protocols such as PUVA or NB-UVB significantly induce the appearance of ANA and other autoantibodies

False

Which autoantibodies are included in the current classification criteria for systemic sclerosis?

a) Anti-centromere (CENP-B); anti-topoisomerase I; and anti-RNA polymerases.

b) Anti-Mi-2; Anti-TIF1-γ; Anti-MDA5

c) Anti-Jo-1; Anti-topoisomerase-1; Anti-RNA polymerase III

d) Anti-fibrillin-1; anti-histones; anti-ssDNA

Anti-centromere (CENP-B); anti-topoisomerase I; and anti-RNA polymerases.

Which of the following is NOT a clinical feature of mixed connective tissue disease (MCTD)?

a) High-titer IgG anti-U1 ribonuclear protein (U1RNP) antibodies

b) Raynaud phenomenon

c) Gottron's papules

d) Esophageal dysmotility

Gottron's papules.

Essay Q1: ◦

Describe the typical morphology and distribution of ACLE lesions, and list three features that help distinguish it from other facial eruptions.

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Essay Q2: Explain the association between ACLE and systemic disease, including the autoantibodies and internal organ involvement that are commonly seen.

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Essay Q3: Discuss the pathogenesis of ACLE, including the inflammatory pathways and cells involved, according to the source

Essay Q4: Compare and contrast the clinical and histological features of ACLE with SCLE and DLE, using information from the text and figures provided in the sources.

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What is the significance of the "butterfly rash" in the diagnosis of ACLE?

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