Subacute Cutaneous Lupus Erythematosus Causes, Treatment: Subacute cutaneous lupus erythematosus is a type between systemic lupus erythematosus and discoid lupus erythematosus, with less invasion of internal organs. Diagnostic points: good for young people, both sexes can be criticized, more common in women. Subacute Cutaneous Lupus Erythematosus Causes, Treatment. Lesions are widely distributed in the cheeks, nose, auricle, trunk, upper arm extension, hand and finger back, and the lesions are scaly erythema-like lesions, like psoriasis or pruritus. Cyclic, multi-annular, cerebral edema, invasive erythema, associated with telangiectasia and pigmentation. The patient may have a fever, joint pain, and light sensitivity. A few of them have heart and kidney involvement, but they are lighter than the system type. Subacute Cutaneous Lupus Erythematosus Causes, Treatment.
We will Learn:
1: Subacute Cutaneous Lupus Erythematosus Causes
2: Cutaneous Lupus Erythematosus Symptoms
3: Laboratory Inspection
4: History of Systemic Lupus Erythematosus
5: Systemic Lupus Erythematosus Diagnosis
6: Subacute Cutaneous Lupus Erythematosus Treatment
7: Diet Consideration
1: Subacute Cutaneous Lupus Erythematosus Causes
Subacute cutaneous lupus erythematosus (subacute cutaneous 1upus erythematosus, SCLE) is a group of annular erythema or papulosquamous characterized lupus rash, often accompanied by mild to moderate symptoms, more common in middle-aged female ratio About 1:3.
2: Cutaneous Lupus Erythematosus Symptoms:
Subacute skin type lupus erythematosus rash Forms:
1: The papule scales are small papules that gradually enlarge into plaques with a few scales, which may be psoriasis-like or rash-like.
2: The ring-shaped erythema type is edematous papules, gradually expanding around, the center of the skin lesions subsiding, and the periphery is a mild infiltration of edematous erythema, the surface is smooth or covered with a little scale, but there is no obvious hair follicle angle plug, often Annular, multi-shaped or irregular. No scars are left behind, or there may be temporary pigmentation, or persistent telangiectasia and hypopigmentation. Skin lesions are mainly distributed on the face, ears, upper chest, shoulders and back of the hand.
3: Patients often have varying degrees of systemic symptoms such as joint pain, low fever, fatigue, and myalgia. Light sensitivity is also more common. Generally, the kidney and central nervous system are less damaged.
Subacute cutaneous lupus erythematosus:
1. The rash occurs in exposed areas such as cheeks, nose, lips, scalp, and earrings. If it involves the limbs and trunk, it develops into a pan-type discoid lupus erythematosus ;
2. The main rash is discoid lupus, which manifests as one or several flat papules or plaque lesions in the early stage, gradually expanding to the periphery, forming a ring-shaped or irregular red plaque with micro-bumps, with sticky scales on the surface. Some mild edema, inflammation is obvious; late plaque color darkens, central atrophy, color fades, sticky keratinous scales can be seen at the atrophy, difficult to remove; forcibly removed, the base can be seen dilated hair follicle mouth, scales There is a horny plug at the bottom, and the plaque is left with atrophic scar . If it occurs in the hair, it will cause permanent hair loss ;
3. Atypical rashes include purplish red edema plaques, verrucous lesions, telangiectasia erythema, and frostbite-like lesions.
3: Laboratory inspection:
1. Blood routine: a small number of peripheral blood leukocytes can be reduced;
2. Urine routine: most of the no abnormal changes;
3, ESR: speed up;
4. Immunological serological examination: a small number may have elevated gamma-globulin, rheumatoid factor positive and low titer and positive;
5. Lupus belt test: 90% of the lesion area is positive, and the non-lesional area is negative.
4: History of Systemic Lupus Erythematosus:
It is characterized by hyperkeratosis of the epidermis, hair follicle and sweat hole plug, thickening of the granular layer, atrophy of the spinous cell layer, epidermal mutated, basal cell liquefaction, dermal papillary edema, telangiectasia, and red blood cell overflow, dermal blood vessels and attachment Lymphocyte -based focal infiltration around the device .
5: Systemic Lupus Erythematosus Diagnosis:
It can be initially diagnosed mainly based on the morphology of the rash and mild to moderate systemic symptoms. Laboratory tests can help diagnose. The papular scale should be differentiated from psoriasis and pityriasis rosea. Ring erythema should be differentiated from other skin diseases with ring erythema damage. The latter generally have no obvious systemic symptoms and lack of laboratory abnormalities in subacute cutaneous lupus erythematosus. ‘Subacute Cutaneous Lupus Erythematosus Causes, Treatment’
6: Subacute Cutaneous Lupus Erythematosus Treatment:
- Combination of local treatment and systemic treatment;
- Photosensitive damage is treated with chloroquine and reaction;
- joint swelling and pain and vascular inflammatory damage treated with Tripterygium Wilford.
- Generalized skin lesions and multiple systemic involvements with glucocorticoid therapy;
- Intractable cases are treated with immunosuppressive agents.
1: General Therapy:
- Enhance confidence in overcoming disease;
- Avoid sun exposure, do not eat drugs and vegetables with photosensitivity;
- Moderate work, acute or active SLE patients should rest in bed;
- Try to avoid catching a cold, colds and other infections;
- Improve the body’s resistance, pay attention to nutrition and vitamin supplements.
2: Topical Therapy:
- Glucocorticoid ointment and cream: topical, 1 or 2 times a day;
- Intra-intra-injection: refractory skin lesions can be injected intramuscularly with sedative abalone or prednisolone once a week;
- Local surgical resection: suitable for intractable damage.
3: systemic therapy:
- Chloroquine: 0.25 grams each time, 2 times a day.
- Hydroxychloroquine: 0.4 g each time, 2 times a day.
- Reaction stop: 25mg each time, 3 times a day.
- Tripterygium Wilford tablets: suitable for patients with systemic lupus erythematosus and one of the 1, 2 and 3 systemic treatments for discoid lupus erythematosus and subacute cutaneous lupus erythematosus; each time 20mg, 2~ per day 3 times.
- Glucocorticoid: 1 mild condition: use prednisone daily 20 ~ 40mg, gradually reduce after the disease control; 2 have obvious systemic involvement, with the equivalent of a strong amount of loose daily 60 ~ 100mg, effective The condition can be controlled within 1 to 3 days. If it is invalid, it can increase the original amount by 30% to 50%. After the disease is controlled, the amount will be gradually reduced. 3 Those with severe disease can be treated with methylprednisolone, 1 gram per day. Used for 3 days.
- Immunosuppressant: 1 cyclophosphamide daily 1-3mg per kilogram of body weight; 2 azathioprine: 2 to 4mg per kilogram of body weight per day; 3 tumor canning, daily 0.lmg per kilogram of body weight; 4 cyclosporine A: 5 to 10 mg per kilogram of body weight per day.
Systemic Therapy 4, 5, 6 is indicated for systemic lupus erythematosus and for patients with discoid lupus erythematosus and subacute cutaneous lupus erythematosus with one of the 1, 2 and 3 systemic therapies.
7: Dietary Considerations:
Systemic lupus erythematosus is a common systemic disease involving multiple organs, involving the skin, kidney, lungs, joints, heart, and liver. So, what should you pay attention to in a systemic lupus erythematosus diet?
Lupus erythematosus expert tips: In the daily systemic lupus erythematosus diet should pay attention to the following points:
- Do not eat or eat foods that have enhanced photosensitivity: such as figs, Chinese milk vetch, rapeseed, yellow mud snails and celery, etc., should avoid sunlight after eating. Mushrooms, mushrooms and other cockroaches and certain food dyes and tobacco can also have the potential to induce systemic lupus erythematosus and try not to eat or eat less.
- High-protein diet: SLE patients with kidney damage often have a large amount of protein lost from the urine, which can cause hypoproteinemia. Therefore, it is necessary to add enough high-quality protein to drink more milk, eat more soy products, eggs, and skinny. Protein-rich foods such as meat and fish.
- Low-fat diet: Patients with systemic lupus erythematosus have less activity and poor digestive function. They should eat light and digestible foods, and should not eat greasy foods with more fat.
- Low-sugar diet: Because patients with systemic lupus erythematosus take glucocorticoids for a long time, it is easy to cause steroid- induced diabetes and Cushing’s syndrome. Therefore, it is necessary to properly control the amount of food and eat fewer foods with high sugar content.
- low-salt diet: patients with corticosteroids or kidney damage can easily lead to water and sodium retention, causing edema, so a low-salt diet.
- Supplement calcium to prevent osteoporosis caused by glucocorticoids; eat more vegetables and fruits rich in vitamins.
In short, systemic lupus erythematosus is not an incurable disease. “Subacute Cutaneous Lupus Erythematosus Causes, Treatment” Rational systemic lupus erythematosus treatment and a rational systemic lupus erythematosus diet will make it possible for patients to return to normal life.