Course and prognosis of subacute cutaneous lupus erythematosus. A prospective study of 34 patients
Tebbe, B.; Hoffmann, S.; Orfanos, C.E.
Der Hautarzt; Zeitschrift für Dermatologie Venerologie und verwandte Gebiete 45(10): 690-695
1994
ISSN/ISBN: 0017-8470 PMID: 8002337 Document Number: 428606
34 patients with subacute cutaneous lupus erythematosus (SCLE) were prospectively followed up and examined twice in 1986-1989 and 1990-1991, with a minimal interval of 2 years. The findings obtained were documented in a computerized registry and were evaluated by computer-assisted analysis. Thirty-one women and three men aged 23-66 years at the time of the first documentation (FD) were included in the study. The disease had lasted an average 6.5 years (from a few months to 39 years). Prominent cutaneous manifestations of SCLE were shown by 79.4% of the patients at the first visit compared to 58.8% at the second documentation (SD), whereas the incidence of acrolocalized vasculitis increased (FD 20.6%, SD 41.2%), as did that of Raynaud phenomenon (FD 20.6%, SD 26.5%). Mild extracutaneous symptomatology was found in 70.6% (FD) and in 85.3% (SD) of the SCLE patients. Arthralgia (FD 47%, SD 61.8%) and symptoms suggesting some involvement of the peripheral or central nervous system (FD 29.4%, SD 50%) were noted most frequently. Overall, during the follow-up there was a quantitative mild increase of extracutaneous symptomatology; a significant correlation between the presence of acrolocalized vasculitis and arthralgia was found. In conclusion, the prognosis of SCLE appears rather benign; fulminant courses were not observed. However, the risk of mild systemic involvement clearly increases during the prospective course of the disease, whereby acrolocalized vasculitis can be regarded as a cutaneous marker for extracutaneous manifestations.