SKIN LESIONS: The concept that patients with subacute cutaneous lupus erythematosus (SCLE) skin lesions represent a distinct lupus erythematosus subset was proposed in 1979 by Sontheimer and supported by many studies. Skin lesions are papulo-squamous, psoriasiform or annular. Photosensitivity is a common complaint and photo-reproduction is significantly frequent in these patients. They persist for weeks or months and typically heal without atrophy or scarring with hyperpigmentation or more often hypopigmentation.
Systemic involvement: Systemic disease is generally quite mild and the prognostic is usually favourable. High-titer, precipitating antibodies to Ro/SSA and HLA DR2 and/or HLA DR3 are strongly associated with SCLE. In some observations, the relation-ship between SCLE and drugs has been recognized.
Treatment: Antimalarial agents are first line systemic treatment. Other therapies, including Thalidomide are helpful for patients with resistant disease. The pathomechanisms of photosensitive SCLE involved antigens Ro/SSA, epidermal and dermal cytokines, intercellular adhesion molecules, mononuclear cells.