SUB-ACUTE
CUTANEOUS
LUPUS
ERYTHEMATOSUS
(SCLE)



Sub-acute cutaneous lupus erythematosus or SCLE involves a discoid rash that can coexist with both discoid & systemic lupus, but may also be a 'bridge' between Discoid LE & Systemic LE.

This type of specific lupus lesion was most recently described during the late 1970's.

This lesion is characterized as a non-scarring, erythematosus, or red, coin-shaped lesion which is very photosensitive, meaning it gets worse when exposed to UV light.

This type of lesion, occurs in lupus patients who, approximately half of the time, demonstrate features of systemic lupus erythematosus.

This form of LE comprises up to 10% of SLE cases and is usually characterised by the presence of persistent macular or slightly raised erythematous lesions on the upper trunk/torso and arms.

These skin lesions may also occur in people who only have clinical evidence of skin disease (discoid lupus), and do not show any symptoms of systemic lupus.

The subacute cutaneous lupus lesion can sometimes mimic the lesions of psoriasis or they can appear as non-scarring, coin-shaped lesions much like hives.

These lesions can also occur on the face in a butterfly distribution (malar), and similar to rosacea, as well as covering large areas of the body.

Unlike the discoid lupus lesions, these lesions do not produce permanent scarring, but can be of major cosmetic significance to the patient involved.
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CLICK IMAGE FOR
ENLARGMENT
scle facial lesions
OF PICTURE
OF SCLE RASH


SCLE is sometimes described as a disease midway between SLE and DLE, but as well, it can coexist with both SLE and DLE.

The SC rash is seen in about 20% of patients exhibiting symptoms typical of discoid lupus.

SCLE doesn't scar the skin, and the lesions do not usually itch.

Although usually a disease of benign nature, some SCLE patients develop severe life-threatening disease.

Cutaneous vasculitis is a common occurrance with SCLE.

Renal disease, however, is unusual in these patients.
SCLE appears to affect primarily white females.

Of the people affected by SCLE, 85% are extremely photosensitive.

Approximately 70% of people affected by SCLE have a positve test for anti-Ro (SSA).

Approximately 60 to 81% of patients with SCLE have positive ANAs, but only about 50% of the positive ANAs are of a significant titer.

SCLE is treated using antimalarials, steroids and cytotoxic drugs if sun protection and cortisone creams are not sufficient.

Prognosis is good when patients are compliant with their treatments and monitored regularly as it tends to be benign and life threatening systemic involvement tends to be uncommon.