Cutaneous lupus erythematosus (CLE) can be divided into three main subtypes: acute, subacute, and chronic, all of which exhibit photosensitivity.

Acute cutaneous lupus erythematosus (ACLE) often presents as symmetrical erythema on the malar cheeks and nasal bridge without involvement of the nasal folds (butterfly rash).

Subacute cutaneous lupus erythematosus (SCLE) typically appears as annular or psoriasiform plaques on sun-exposed areas.

Chronic cutaneous lupus erythematosus (CCLE) can be divided into three main types: discoid lupus erythematosus (DLE), Tumid lupus erythematosus, and lupus panniculitis. Tumid lupus usually presents with raised lesions and plaques that do not crust and heal without scarring, while lupus panniculitis involves the subcutaneous tissue and leads to painful subcutaneous nodules that heal with indentation and atrophy.

In discoid lupus, erythematous and purple lesions with crusts and atrophy appear more on the face, head and limbs. The probability of becoming systemic lupus is about 15%.

Patients may report mild itching or occasional pain or burning within the lesions, but most patients are asymptomatic. According to one study, approximately 16% of patients with discoid lupus erythematosus (DLE) may develop systemic involvement within 3 years of diagnosis.

Diagnosis:

Patients may present with any symptom of SLE. Therefore, the history should include a complete review of laboratory tests, joint pain or joint involvement, pulmonary involvement, cardiac involvement, neurological involvement, and kidney involvement. A skin biopsy is required for a definitive diagnosis of cutaneous lupus.

DLE can involve scalp hair, in which case the treatment should start early, because if the treatment is delayed, the lost hair will not grow back.

Treatment :

In case of skin involvement, the only treatment includes topical or oral corticosteroids and immunosuppressive drugs.