Maria Apparecida Constantino Vilela

Lupus erythematosus: Clinical and histopathological study of oral manifestations and immunohistochemical profile of the inflammatory infiltrate

Background:  Lupus erythematosus (LE) is a multifactorial autoimmune disease, which may affect the oral mucosa in either its cutaneous and systemic forms, with varied prevalence.

Discoid Lupus Erythematosus in Children—A Retrospective Study of 34 Patients

Abstract:  Discoid lupus erythematosus is much less frequent and studied in children. We undertook a retrospective study of 34 children less than 16 years of age with this disease, seen over a period of 9 years. A female predominance of 2:1 was found. An association between discoid lupus erythematosus and systemic lupus erythematosus was observed in 23.5% of patients, a higher proportion compared to adult discoid lupus erythematosus. Disseminated lesions were much more frequent in patients with criteria for systemic lupus erythematosus (87.5% vs 34%), suggesting that it could be associated with a worse prognosis. Histologic findings were similar to those observed in adult discoid lupus erythematosus.

Lupus erythematosus: clinical and histopathological study of oral manifestations and immunohistochemical profile of epithelial maturation

Background:  Lupus erythematosus (LE) is an autoimmune disease of unknown cause. Prevalence of oral involvement in patients with LE is uncertain but may vary from 9 to 45% in patients with systemic disease and from 3 to 20% in patients with chronic cutaneous involvement.

Direct immunofluorescence in lupus erythematosus (LE)

One hundred and twenty-six patients with LE were studied. They were distributed as follows: 84 with DLE, 13 with SALE and 29 with SLE. Biopsies from the skin lesions were performed and submitted to DIF. Positive results were equal to 69, 61.5 and 72.4 percent of the DLE, SALE and SLE cases, respectively. These data are in accordance with the literature. IgM was the most frequently found immunoglobulin, followed by the association IgM + C3.

Blisters on the legs.

A 24-year-old man (patient 1) with a 3-year history of severe pruritus affecting the pretibial areas presented with erythematous/violaceous keratotic and crusting lesions with paucity of blisters on the lower limbs. The blisters appeared after mild trauma and healed as severely pruritic papules. The frequency of new lesions had increased in recent years. The patient’s 50-year-old father and his 45-year-old brother (patients 2 and 3) presented with extremely disfiguring and strikingly linear raised lesions that had occurred during the past 40 years. Severe pruritus and occasional blisters were associated. With age, the occurrence of new blisters reduced, but the pruritic lesions persisted and increased. Lesions initially developed on the extensor aspects of the lower limbs, extending to involve the complete surface of both arms and legs (Fig. 1). All three patients presented rudimentary and dystrophic finger nails and there were no mucosal or milialike lesions. Systemic examination was unremarkable. No other family members were affected and there was no consanguinity. Serum levels of IgE, thyroid hormones and ferritin, and routine blood and urine examinations were normal.

Avaliação dos efeitos adversos desencadeados pelo uso de difosfato de cloroquina, com ênfase na retinotoxicidade, em 350 doentes com lúpus eritematoso

BACKGROUND: The occurrence of antimalarial retinopathy is reducing all over the world, but are few brazilian studies. OBJECTIVES: Analysis of the occurrence of adverse effects, triggered by use of 250mg/d of chloroquine diphosphate in 350 patients with for lupus erythematosus. METHODS: Review of clinical records and analysis between adverse effects and the daily dose per kg, age and the differents types of lupus erythematosus; and the periodicity of ophthalmologic screening. RESULTS: 35,7% of adverse effects, ocular toxicity (17,4%): retinal pigmentation suggestive of antimalarial retinopathy (12%), corneal deposits (3,1%) and acute visual symptoms(2,3%); gastrointestinal (10%), cutaneous (3,4%), headache (2,9%), neuromuscular (1,7%) and psychiatric (0,3%). Antimalarial retinopathy confirmed in 2,6%. No statistically significant association between occurrence of adverse effects and retinotoxicity with the daily dose per kg and the type of lupus erythematosus. Retinotoxicity was statistically significant (p=0,004) in patients over 50 years. Ophthalmologic screening was conducted on average after 10,5 months. CONCLUSIONS: Antimalarial retinopathy occurred in 2,6% of the patients. Ophthalmologic screening had to be more careful in patients over 50 years because the difficulty to differentiate between initial antimalarial retinopathy and senile macular degeneration.BACKGROUND The occurrence of antimalarial retinopathy is reducing all over the world, but are few brazilian studies. OBJECTIVES Analysis of the occurrence of adverse effects, triggered by use of 250mg/d of chloroquine diphosphate in 350 patients with for lupus erythematosus. METHODS Review of clinical records and analysis between adverse effects and the daily dose per kg, age and the differents types of lupus erythematosus; and the periodicity of ophthalmologic screening. RESULTS 35,7% of adverse effects, ocular toxicity (17,4%): retinal pigmentation suggestive of antimalarial retinopathy (12%), corneal deposits (3,1%) and acute visual symptoms(2,3%); gastrointestinal (10%), cutaneous (3,4%), headache (2,9%), neuromuscular (1,7%) and psychiatric (0,3%). Antimalarial retinopathy confirmed in 2,6%. No statistically significant association between occurrence of adverse effects and retinotoxicity with the daily dose per kg and the type of lupus erythematosus. Retinotoxicity was statistically significant (p=0,004) in patients over 50 years. Ophthalmologic screening was conducted on average after 10,5 months. CONCLUSIONS Antimalarial retinopathy occurred in 2,6% of the patients. Ophthalmologic screening had to be more careful in patients over 50 years because the difficulty to differentiate between initial antimalarial retinopathy and senile macular degeneration.