P. Lebozec et al., CHRONIC CUTANEOUS LUPUS-ERYTHEMATOSUS IN THE LUPUS-ERYTHEMATOSUS SPECTRUM - RETROSPECTIVE STUDY OF 136 PATIENTS, La Presse medicale, 23(35), 1994, pp. 1598-1602
Objectives: The aim of this retrospective study of 136 patients was to
specify the natural history and the systemic prognosis of chronic cut
aneous lupus erythematosus, It has been stated that in most of the cas
es, the disease only affects the skin. Methods: From 10 October 1980 t
o 31 December 1990, 136 patients with the following criteria were incl
uded in this retrospective study: clinical signs suggestive of chronic
cutaneous lupus erythematosus, characteristic histology, insufficient
evidence for the diagnosis of systemic lupus erythematosus. Results:
The prevalence of systemic clinical involvement in the population unde
r study was nearly the same as in the general population. The followin
g biologic or immunologic abnormalities were quite common: leukopenia,
lymphopenia, thrombopenia (significantly more frequent among patients
having widespread chronic cutaneous lupus erythematosus), low titers
of complement levels, positive antinuclear antibodies (usually at a lo
w titer). Eleven out of the 136 patients developed systemic lupus eryt
hematosus, most often over 5 years after the onset of the cutaneous le
sions. Four cases out of these 11 had poor prognosis: renal and/or neu
rologic involvement. Conclusion: This data suggests that patients with
chronic cutaneous lupus erythematosus could benefit from long-term fo
llow up, since the course to systemic disease occurs in only a few. Us
ually, antimalarials used singly or in combination with topical steroi
ds may lead to the clearing of the lesions. Thalidomide will occasiona
lly be useful whenever the disease is unresponsive to the preceeding m
easures.