ACLE Study Qs

Okay, here are some multiple-choice and true/false questions about lupus erythematosus (LE) and related conditions, based on the provided sources, as well as short answer and essay-style questions related to acute cutaneous lupus erythematosus (ACLE), as requested:

Multiple Choice and True/False Questions

True/False: Population-based studies suggest that there are more patients with cutaneous LE without systemic lupus erythematosus (SLE) than patients with SLE.
- a) True
- b) False
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
True/False: A lichenoid tissue reaction, characterized by epidermal basal cell damage and a band-like lymphocytic infiltrate in the upper dermis, is a feature of most subsets of cutaneous LE.
- a) True
- b) False
The term "lupus erythemateaux" was first used by:
- a) Hutchinson
- b) Osler
- c) Cazenave
- d) Jadassohn
In 1979, the entity now known as subacute cutaneous lupus erythematosus (SCLE) was clearly separated and named by:
- a) Dubois
- b) Gilliam, Sontheimer, and Thomas
- c) Maddison, Provost, and Reichlin
- d) 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
True/False: Patients with discoid LE (DLE) lesions have a high likelihood of progressing to SLE.
- a) True
- b) False
Which of the following is a typical characteristic of SCLE lesions?
- a) Lesions favor the head and neck region.
- b) Lesions are often found on the palms and soles.
- c) Lesions may have an annular configuration with raised borders and central clearing
- d) Lesions show significant scarring.
True/False: The malar rash of ACLE typically spares the nasolabial folds.
- a) True
- b) False
Which of the following autoantibodies is NOT specifically associated with SLE?
- a) Anti-dsDNA
- b) Anti-Sm
- c) Anti-SSA/Ro
- d) Anti-RNP
Which of the following 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.

True/False: According to the 2019 EULAR/ACR classification criteria for SLE, a positive ANA test (titer ≥1:80) is an entry criterion.
- a) True
- b) False
According to the 2019 EULAR/ACR classification for SLE, how many points are given for subacute or discoid lupus if observed by a clinician?
- a) 2 points
- b) 3 points
- c) 4 points
- d) 6 points
True/False: Drug-induced SLE commonly presents with nephritis and CNS disease.
- a) True
- b) False
According to the SLICC classification system for SLE, a diagnosis of SLE is based on having at least how many of 17 criteria, and must include at least 1 clinical and 1 immunologic criterion?
- a) 2
- b) 3
- c) 4
- d) 5
Which of the following is a typical feature of ACLE?

a) Chronic, relapsing course.
b) Annular configuration with raised borders.
c) "Butterfly rash"
d) Significant scarring

Which of the following 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)
True/False: Patients with SLE have more prominent nail-fold capillary abnormalities than patients with systemic sclerosis.
- a) True
- b) False
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

Which of the following 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
True/False: 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
- a) True
- b) False
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.

a) True
b) False

True/False: Phototherapy protocols such as PUVA or NB-UVB significantly induce the appearance of ANA and other autoantibodies.
- a) True
- b) False
According to the source, which of the following 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
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

Short Answer and Essay Style Questions on ACLE

Describe the typical morphology and distribution of ACLE lesions, and list three features that help distinguish it from other facial eruptions.
Explain the association between ACLE and systemic disease, including the autoantibodies and internal organ involvement that are commonly seen.
Discuss the pathogenesis of ACLE, including the inflammatory pathways and cells involved, according to the source.
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.
What is the significance of the "butterfly rash" in the diagnosis of ACLE?

Answers to Multiple Choice and True/False Questions

a) True
d) Genetic predisposition
a) True
c) Cazenave
b) Gilliam, Sontheimer, and Thomas
d) Intermittent cutaneous LE
b) False
c) Lesions may have an annular configuration with raised borders and central clearing
a) True
c) Anti-SSA/Ro
b) Periadnexal inflammation and follicular plugging
a) True
a) 2 points
b) False
c) 4
c) "Butterfly rash"
d) Subacute cutaneous LE (SCLE)
b) False
d) Gottron's papules
b) Superficial and deep dermis perivascular and periadnexal
a) True
a) True
b) False
a) Anti-centromere (CENP-B); anti-topoisomerase I; and anti-RNA polymerases.
c) Gottron's papules