From the Guidelines
Systemic lupus erythematosus (SLE) patients often present with distinctive skin manifestations that can aid in diagnosis, including the butterfly or malar rash, discoid lesions, photosensitive rashes, oral or nasal ulcers, cutaneous vasculitis, and hair loss (alopecia) 1. The most recognizable image is the butterfly or malar rash, which appears as a red, raised rash across the cheeks and bridge of the nose, resembling a butterfly shape. Other common visible signs include:
- Discoid lesions (circular, red, scaly patches that can scar)
- Photosensitive rashes that worsen with sun exposure
- Oral or nasal ulcers
- Cutaneous vasculitis presenting as small red or purple spots on the skin, particularly on the legs
- Hair loss (alopecia) In advanced cases, patients may show signs of joint deformities from arthritis or exhibit cushingoid features if on long-term corticosteroid therapy. The skin manifestations often correlate with disease activity and may improve with appropriate treatment, which typically includes antimalarials like hydroxychloroquine, corticosteroids, and immunosuppressants depending on disease severity 1. It is essential to monitor SLE patients regularly, using global and organ-specific activity indices such as the British Isles Lupus Assessment Group Scale (BILAG), European Consensus Lupus Activity Measure (ECLAM), and the Systemic Lupus Erythematosus Disease Activity Index (SLEDAI) to evaluate disease activity and predict future flares 1. Regular eye assessments are also crucial, particularly for patients on antimalarial drugs, to monitor for retinopathy and other eye complications 1.
From the Research
Characteristic Images of Systemic Lupus Erythematosus (SLE)
- The characteristic images of SLE are not explicitly described in the provided studies 2, 3, 4, 5, 6.
- However, the studies mention various clinical manifestations and organ involvement that may be associated with SLE, such as:
- Mucocutaneous manifestations (e.g. rash, skin lesions) 3, 4, 6
- Musculoskeletal manifestations (e.g. arthritis, myositis) 3, 4, 6
- Hematologic manifestations (e.g. cytopenia, anemia) 3, 4, 6
- Renal involvement (e.g. lupus nephritis, proteinuria) 2, 3, 4, 5, 6
- Neuropsychiatric manifestations (e.g. seizures, psychosis) 4, 6
- Cardiovascular manifestations (e.g. myocarditis, pericarditis) 6
- Pulmonary manifestations (e.g. pneumonitis, pleuritis) 6
- Reproductive manifestations (e.g. miscarriage, fetal growth restriction) 6
- These manifestations may be associated with various imaging findings, such as:
- Skin lesions or rashes on physical examination 3, 4, 6
- Joint inflammation or damage on radiographs or MRI 3, 4, 6
- Abnormal blood cell counts or electrolyte levels on laboratory tests 3, 4, 6
- Renal damage or dysfunction on ultrasound, CT, or MRI 2, 3, 4, 5, 6
- Neuropsychiatric symptoms or signs on physical examination or neuroimaging studies 4, 6
- Cardiovascular or pulmonary abnormalities on echocardiogram, chest X-ray, or CT scan 6
- Reproductive complications on ultrasound or other imaging modalities 6