Lupus Erythematosus
Epidemiology:
Common sites:
Gross features:
- poorly-defined malar erythema (typical in SLE)
- “discoid” plaques –
large, sharply demarcated erythematous shiny or
scaling plaques (SLE or DLE)
- wrinkling on
lateral compression
- telangiectasia
- zones of hypopigmentation and hyperpigmentaiton
- small, keratotic plugs in follicular ostia
(hand lens)
Histologic features:
- lymphocytic infiltrate:
- dermoepidermal junction AND/OR
- dermal-follicular
epithelial junction
- deep perivascular and periappendageal
- lupus profundus:
- preferential
infiltration of subcutaneous fat
- diffuse vacuolation of basal layer
- marked atrophy of
epidermis
- variable
hyperkeratosis
- hair follicle involvement:
- epithelial
atrophy
- dilated,
keratin-plugged infundibula
- marked thickening
of basement membrane (PAS)
Immunophenotype:
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Marker:
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Sensitivity:
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Specificity:
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- immunofluorescence:
- immunoglobulin
and complement
- granular band
along dermoepidermal and dermal-follicular
junctions
- may be seen in
normal skin in SLE
Molecular features:
Other features:
- systemic and
discoid lupus erythematosus lesions are histologically indistinguishable
- sun-exposure may
elicit or worsen lesions
- DLE:
- Usually do not
go on to develop systemic disease
- Formation and
deposition of immune complexes and complement components C5b to C9 (MAC) at dermoepithelial
junction
References: