SCLE

What is Subacute Cutaneous Lupus Erythematosus (SCLE)?

A subtype of cutaneous lupus erythematosus characterized by photosensitive lesions appearing on sun-exposed skin.

What types of lesions are common in SCLE?

Lesions are typically annular or papulosquamous and resolve without scarring.

Which autoantibody is often associated with SCLE?

Anti-SSA/Ro autoantibodies.

Where are SCLE lesions most commonly found on the body?

Lesions are common on the sides of the face, upper trunk, and extensor surfaces of the upper extremities, with the midface usually spared.

What environmental factor is a significant trigger for SCLE?

Ultraviolet radiation (UVR).

How does UV radiation contribute to the pathogenesis of SCLE?

UVR induces apoptosis, leading to the translocation of cellular and nuclear antigens and increases keratinocyte production of type I interferons.

What is a common long-term consequence of SCLE lesions?

Dyspigmentation, particularly hypopigmentation.

Which class of medications is a common trigger for drug-induced SCLE?

Medications such as terbinafine, TNF inhibitors, and anti-epileptics.

What type of dermatitis is observed histologically in SCLE lesions?

Mild interface dermatitis with sparse superficial lymphoid infiltrates.

What is the role of anti-SSA/Ro autoantibodies in SCLE?

These autoantibodies are strongly associated with SCLE and play a significant role in its pathogenesis.

What is the importance of a lesional biopsy in SCLE diagnosis?

A lesional biopsy helps identify characteristic histopathological features of SCLE.

What does the SLICC classification system define SCLE by?

Non-indurated psoriasiform and/or annular polycyclic lesions that resolve without scarring.

What are typical features of SCLE lesions?

Photosensitivity, annular plaques with raised pink-red borders, and minimal palpability.

What should be included in the systemic evaluation for SCLE?

Directed history, physical examination, blood tests including ANA profile, urinalysis, CBC, and chemistries.

How do SCLE lesions typically resolve?

SCLE lesions typically resolve without scarring, although dyspigmentation may occur.

Which demographic is more commonly affected by SLE, which may be associated with SCLE?

Women, especially those in their childbearing years.

How is SCLE typically managed?

Management includes topical corticosteroids, systemic antimalarials, and sun protection.

What is a key consideration in patients with SCLE regarding their medication?

Drug-induced SCLE should always be considered, and discontinuation of the causative medication is important.

Can SCLE lead to systemic involvement?

Most patients do not have serious systemic involvement, but some may develop systemic lupus erythematosus (SLE).