Skin nontumor
Lichenoid and interface reaction patterns
Chronic cutaneous lupus

Topic Completed: 1 August 2011

Minor changes: 11 January 2021

Copyright: 2002-2021,, Inc.

PubMed Search: Lupus: systemic lupus erythematosus [title] skin

Mowafak Hamodat, M.B.Ch.B., M.Sc.
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Cite this page: Hamodat M. Chronic cutaneous lupus. website. Accessed January 22nd, 2021.
Clinical features
  • Relatively common autoimmune disease of women, due to anti-DNA antibodies
  • Fatigue, fever, arthritis, erythematous, bilateral butterfly (malar) rash of the face, renal disease, lymphadenopathy, and serositis
  • Associated with altered immunity, drugs, viruses, genetic predisposition, hormones and ultraviolet light
  • Exacerbated by sunlight
  • Discoid lupus type lesions in 33%
  • Cutaneous lesions take the form slightly indurated patches with minimal scale
Clinical images

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Malar rash of face

Microscopic (histologic) description
  • Fibrinoid necrosis at dermoepidermal junction with liquefactive degeneration and atrophy of epidermis
  • More mucin deposition in reticular dermis than discoid lupus
  • Edema, small hemorrhages and a mild infiltrate of inflammatory cells, principally lymphocytes, in upper dermis
  • Eosinophils in drug induced cases and urticarial lesions
  • Fibrinoid material is deposited in the dermis around capillary blood vessels, on collagen and in the interstitium
  • In nonbullous cases, neutrophils are sometimes present in the upper dermis, both perivascular and interstitial with leukocytoclasis
Positive stains
  • IgG, IgM and C5b-C9 (by direct immunofluorescence) in clinically involved skin as an irregular band at dermoepidermal junction
  • IgG and IgM in 50% of cases in normal skin
  • Also antibodies for ANA, rheumatoid factor, anti-double stranded DNA, ENA
Differential diagnosis
  • Polymorphous light eruption
  • Jessners lymphocytic infiltration of skin
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