TUMID LUPUS ERYTHEMATOSUS

Course overview

TUMID LUPUS ERYTHEMATOSUS (TLE) IS CURRENTLY CONSIDERED A SUBTYPE OF CUTANEOUS LUPUS ERYTHEMATOSUS (CLE). TLE DIFFERS FROM THE OTHER SUBTYPES OF CUTANEOUS LUPUS ERYTHEMATOSUS IN THAT AN ASSOCIATION WITH SYSTEMIC LUPUS ERYTHEMATOSUS (SLE) IS RARE. BECAUSE OF THIS WEAK ASSOCIATION WITH SLE AND A RELATIVE LACK OF SEROLOGIC ABNORMALITIES IN PATIENTS WITH TLE, SOME CONSIDER TLE TO BE A SEPARATE ENTITY FROM LUPUS. IT HAS ALSO BEEN POSTULATED THAT TLE IS ON A CLINICAL GRADIENT WITH LYMPHOCYTIC INFILTRATE OF JESSNER AND RETICULAR ERYTHEMATOUS MUCINOSIS (REM) DUE TO SIMILAR FINDINGS ON HISTOLOGY. TUMID LUPUS ERYTHEMATOSUS (TLE) TYPICALLY PRESENTS AS ANNULAR, INDURATED, ERYTHEMATOUS, EDEMATOUS PLAQUES WITHOUT EPIDERMAL INVOLVEMENT. IF ANY OF THESE FEATURES ARE RECOGNIZED, EPIDERMAL INVOLVEMENT IS LIKELY, AND A DIAGNOSIS OF DLE SHOULD BE SUSPECTED. TYPICAL LOCATIONS OF TLE ARE THE FACE AND TRUNK, AND LESIONS RESPOND WELL TO PHOTOPROTECTION, TOPICAL CORTICOSTEROIDS, AND ANTIMALARIALS. THIS ACTIVITY REVIEWS THE PRESENTATION, EVALUATION, AND MANAGEMENT OF TUMID LUPUS ERYTHEMATOSUS AND STRESSES THE ROLE OF AN INTERPROFESSIONAL TEAM APPROACH IN THE CARE OF AFFECTED PATIENTS.