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Author: Brian Wu, MD candidate, Keck School of Medicine, Los Angeles, USA. DermNet New Zealand Editor in Chief: Hon A/Prof Amanda Oakley, Dermatologist, Hamilton, New Zealand. Copy editor: Maria McGivern. March 2017.
Lupus erythematosus (LE) is a group of chronic, autoimmune diseases that may affect multiple organs. It often involves the skin, with acute, subacute, intermittent, chronic and nonspecific forms. Cutaneous disease is a feature of systemic LE in around 70% of patients.
Common manifestations of cutaneous LE include:
Cutaneous LE can have a profound effect on the individual’s mental and physical health.
The cutaneous manifestations of LE often result in depression and psychological stress. It is estimated that 20–40% of patients with cutaneous LE suffer from emotional problems.
Cutaneous LE affects nearly every aspect of a person’s life, including their family and other social relationships.
The very poor quality of life seen in patients with cutaneous LE is comparable to that seen in patients with other serious chronic conditions such as congestive heart failure and diabetes.
The Cutaneous Lupus Activity and Severity Index (CLASI) is a tool that is used to assess the effects of cutaneous LE on the individual. It ranks the activity of the disease on a scale of 0–70 (the higher the number, the greater the severity) and the damage it has done on a scale of 0–56 (the higher the number, the larger the level of dyspigmentation and scarring).
The Skindex-29 questionnaire and the Dermatology Life Quality Index (DLQI) can also be used to assess the quality of life for patients with chronic skin conditions, including cutaneous LE.
The treatment for cutaneous LE may require collaboration between a dermatologist and a psychologist or psychiatrist to deal with both the physical and psychological effects of the disease.
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