Skin pathology in systemic lupus erythematosus

Systemic lupus erythematosus (SLE) − a systemic connective tissue disease that develops on the basis of a genetically determined imperfection of immunoregulatory processes, which leads to the formation of many antibodies to one's own cells and their components, as well as the emergence of immunocomplex inflammation, which results in damage to many organs and systems.

At the heart of the development of SLE − loss of immunological tolerance, polyclonal B-lymphocyte activation and production of antibodies that react with a wide range of autoantigens, which determine the polysystemic nature of the pathological process. What skin changes occur in systemic lupus erythematosus read on estet-portal.com.

• Features of the course of systemic lupus erythematosus
• Skin in systemic lupus erythematosus
• Strategies for the treatment of skin manifestations of systemic lupus erythematosuski

Features of the course of systemic lupus erythematosus

SCR − the most severe and widespread chronic disease, which, when vital systems and organs are affected, is potentially life-threatening, but in most cases SLE is characterized by the development of a chronic debilitating pathological condition for the patient .

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The incidence of SLE in the general population depends on its individual characteristics (in particular, age, sex, race, ethnicity/nationality, and the period of the year when data is collected), as well as changes in generally accepted classification criteria.

SLE flare-ups can occur during times of rapid hormonal changes.

During the menstrual cycle, cyclic fluctuations in the activity of the disease are characteristic. Patients with debut in the postmenopausal period are characterized by lower disease activity and a better prognosis.

Skin in systemic lupus erythematosus

Cutaneous lupus is the second most common clinical manifestation of skin lesions, occurring in almost 85% of patients. In addition, there are a significant number of patients with  symptoms characteristic of cutaneous lupus, the latter being 2 or 3 times more common than SLE.

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Among trigger factors for the occurrence of cutaneous lupus it is customary to consider:

• UV irradiation;
• drugs;
• hormones;
• stress;
• viruses;
• traumatic skin injury. 

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In the induction of the occurrence of specific lesions in cutaneous lupus, the following play a role: & nbsp; apoptosis, necrosis, T- and B-lymphocytes and plasma cells are involved in the process. In addition, the participation of autoantibodies and the presence of functional and organic changes in the vessels are important. 

In turn, specific  skin manifestations of SLE are commonly classified depending on the severity of the process into:

1. acute cutaneous lupus (occurs in 30-50% of patients with specific skin lesions);
2. subacute cutaneous lupus (10-15% of patients with specific skin lesionszhi);
3. chronic cutaneous lupus (15-20% of patients, respectively).

Strategies for the treatment of skin manifestations of systemic lupus erythematosus

All current therapeutic strategies for the treatment of cutaneous manifestations of SLE are based solely on individual reports in the literature, as well as on the long experience of dermatologists.

This state of affairs is explained by the heterogeneity of the spectrum of clinical manifestations of skin lesions in SLE

, the lack of double-blind, randomized, placebo-controlled trials, and the use of drugs, mainly officially "approved" for use in this type of pathology.  

 

Among the main directions 

of the optimal therapeutic strategy

 management of patients with cutaneous manifestations of SLE, the following should be highlighted:

UV protection;

1. local therapy;
2. systemic therapy.
3. Traditional recommendations for protecting SLE patients from UV exposure
:

Minimizing exposure to UV radiation, which is achieved by avoiding sun exposure from 10:00 am to 4:00 pm. Daily UV Index check is important;

Avoid taking photosensitizing agents;

1. Use UV protection: wear hats and protective clothing, use UV blocking films at home and in the car. Use broad-spectrum UVA and UVB protective creams and lotions.
Antioxidants, melanogenesis enhancers, tanning stimulation with thymidine nucleotides and neutralization of 
NF

- activity are considered as experimental means of protection against UV radiation >kB. What diagnostic methods in dermatology are of the greatest importance for a specialist?

The local treatment of skin lesions in lupus includes  glucocortitoids, which are used externally, in dressings and applications. In addition, among other drugs, I would like to mention preparations based on calcineurin

 (0.1% tacrolimus ointment, 1% pimecrolimus cream).

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