THE EFFECT OF HORMONAL CHANGES ON CUTANEOUS DISEASE IN LUPUS-ERYTHEMATOSUS

The behaviour of cutaneous disease in systemic lupus erythematosus (SL E) and discoid lupus erythematosus (DLE), under the influence of vario us hormonal states, was studied in 68 patients. In 2 8 pregnancies, cu taneous disease was essentially unchanged. In a total of 5 7 patients whose lupus erythematosus (LE) had been diagnosed prior to the menopau se, 20% described a premenstrual cutaneous exacerbation. Only three pa tients had taken an oestrogen-containing contraceptive. The duration o f oral contraceptive treatment before the onset of lupus varied: 1 mon th in a patient presenting with the acute malar rash of SLE, 2 months in a patient who presented with annular weals and later developed syst emic features, and 12 months in a patient who developed generalized DL E. Thirty-three patients were menopausal at the time of the study, 4% had noticed a perimenopausal cutaneous flare. There was no deteriorati on in the skin of the five patients on hormone replacement therapy.