Subacute cutaneous lupus erythematosus in Child
Acute cutaneous lupus erythematosus (ACLE) associated with systemic lupus erythematosus:
- Transient cutaneous findings typified by malar erythema without scarring.
- Strongly associated with systemic findings.
- Photosensitive cutaneous eruption lasting longer than ACLE but without scarring.
- Children, especially those with C2 deficiency, may have systemic findings.
- Chronic discoid lesions with permanent disfiguring scars.
- Up to 25% of children go on to develop systemic findings.
There is a strong association with anti-Ro antibodies and SCLE. In a small number of cases reported, both sexes seem equally involved, and there is no association with particular ethnic groups. Although drugs are commonly associated with SCLE in adults, this has not been the case in children.
Sinopulmonary infections and meningitis have been associated with those cases involving C2 deficiency. A rare patient has had factor H deficiency, a protein controlling C3 catabolism.
L93.1 – Subacute cutaneous lupus erythematosus
239891002 – Subacute cutaneous lupus erythematosus
- Granuloma annulare – Mainly in children and young adults; biopsy will help differentiate granuloma annulare and SCLE. Facial lesions are extremely rare.
- Tinea corporis – Usually has scale at the leading edge. Check KOH.
- Erythema marginatum – Seen more commonly in children; cutaneous feature of acute rheumatic fever.
- Polymorphous light eruption – Most lesions resolve within several days.
- Erythema multiforme – Characteristic target-like lesions; tends to involve the palms.
- Annular psoriasis – Biopsy will assist in differentiating psoriasis from SCLE.
- Annular urticaria – Wheals that are characteristically pruritic.
- Erythema annulare centrifugum (EAC) – Mostly seen on hips and thighs in patients in their 50s; biopsy can help differentiate EAC from SCLE. Usually has scale trailing the leading edge.
- Sarcoidosis – More infiltrative plaques.
- Lichen planus – Pruritic scaly papules that involve the wrists, forearms, genitalia, and presacral area; biopsy will assist in differentiating lichen planus from SCLE.
- Syphilis (see secondary syphilis) – Check RPR.
- Drug-induced photosensitive reaction
- Drug-induced photoallergic reaction