Etiology • An autoimmune-/immunologically mediated condition • Antibodies demonstrable against an array of cytoplasmic and
nuclear antigens • Most often occurs in women
Clinical Presentation • Three forms are as follows:
• Chronic cutaneous (CCLE) or discoid (DLE) • Subacute cutaneous (SCLE) • Systemic (SLE)
• Black females have highest incidence • Predominates in women over 40 years • 80% of patients have concurrent cutaneous findings • 30 to 40% of SLE patients have oral mucosal findings • Oral mucosal lesions may appear lichenoid, keratotic, and
erosive. • Labial vermilion with crusted, exfoliative, erythematous, and
nuclear antigens • Most often occurs in women
Clinical Presentation • Three forms are as follows:
• Chronic cutaneous (CCLE) or discoid (DLE) • Subacute cutaneous (SCLE) • Systemic (SLE)
• Black females have highest incidence • Predominates in women over 40 years • 80% of patients have concurrent cutaneous findings • 30 to 40% of SLE patients have oral mucosal findings • Oral mucosal lesions may appear lichenoid, keratotic, and
erosive. • Labial vermilion with crusted, exfoliative, erythematous, and
keratotic appearance • Oral findings are most common in CCLE or DLE.
Diagnosis • Direct immunofluorescent examination of mucosal biopsy • Serologic correlation (antinuclear antibodies: anti–SS-A, –SS-B,
and double-stranded deoxyribonucleic acid) Differential Diagnosis
• Lichen planus • Candidiasis • Hypersensitivity/lichenoid eruption • Leukoplakia
Treatment • Complex—dependent on LE variant present and level of disease
expression • Systemic corticosteroids and immunosuppressive agents for SLE • Topical corticosteroid agents for intraoral lesions • Low-dose hydroxychloroquine • Intralesional corticosteroid injections
Prognosis • Good prognosis with CCLE or DLE form • Variable prognosis with SLE • SCLE has an intermediate prognosis between that of SLE and
CCLE or DLE forms.