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[Discoid lupus erythematosus beginning on the eyelids].

We report on a 20-year-old women, who suffered from discoid lupus erythematosus (DLE) beginning on her eyelids with dyschromia and cutaneous infiltration. Similar signs appeared on the top of her nose, her nostrils, and her lower lip. Simultaneously with these alterations, we found a superficial exulceration on her hard palate, which histologically proved typical for DLE. After therapy with chloroquine for 3 weeks, the alterations disappeared.

Adolescent↗

In situ identification of mononuclear cells in cutaneous infiltrates in discoid lupus erythematosus, sarcoidosis and secondary syphilis.

The inflammatory mononuclear cell infiltrates observed in lesional skin from patients with discoid lupus erythematosus (DLE), sarcoidosis, and secondary syphilis have been characterized in situ. Immunological markers (human T lymphocyte antigens and receptors for sheep erythrocytes, C3b, C3d and Fc gamma) were studied by using immunofluorescence tests with IgG F (ab')2 preparation of anti-T lymphocyte serum, hemadsorption with tissue sections, and tests with soluble immune complexes of peroxidase. In DLE, T lymphocytes were the dominant cell type. In sarcoidosis, the epithelioid cells, including giant cells, had markers similar to macrophages. The lymphohistiocytic cells consisted mainly of macrophages, some T lymphocytes and a few B lymphocytes. In secondary syphilis (condylomata lata), macrophages and T lymphocytes were the dominant cell types, and relatively few B lymphocytes were detected.

Antigens↗

Discoid lupus erythematosus developing in areas where fragments of windshield glass had become embedded in the skin.

We observed a 26-year-old female patient with discoid lupus erythematosus on her left cheek skin, where fine fragments of windshield glass had been embedded in an automobile accident 8 years previously. She gradually developed general fatigue, morning stiffness of fingers and anti-nuclear antibody. As an etio-pathogenesis of this patient, we speculate that a long exposure to quartz (silica) could give rise to discoid lupus erythematosus in only local damaged areas and at the same time induce systemic immunological changes in some genetically restricted persons; such as production of anti-nuclear antibody. Silica has multi-potential biological effects, especially on immunological functions.

Accidents, Traffic↗

Canine discoid lupus erythematosus.

Two dogs were found to have clinical, histopathological and immunofluorescent findings compatible with a diagnosis of canine discoid lupus erythematosus. The primary lesions included erythema and depigmentation of the nasal planum. Both dogs responded favorably to systemic corticosteroid therapy.

Animals↗

LE or not LE--that is the question: an unsuccessful attempt to separate lymphocytic infiltration from the spectrum of discoid lupus erythematosus.

Lymphocytic infiltration of the skin (LIS) has been claimed to be a distinct entity that differs from discoid lupus erythematosus (DLE) by the lack of epidermal changes, negative immunofluorescence tests, and differences in the composition of the inflammatory cell infiltrate. In studies that sought to distinguish both conditions, however, cases of established lupus erythematosus without epidermal involvement have not been considered. We studied 72 patients with the clinical and histopathologic diagnosis of either LIS or DLE in regard to the same clinical, histopathologic, immunofluorescence, and immunohistochemical criteria. No significant differences were noted between cases with and without epidermal involvement on the one hand and between cases with and without immunofluorescence or clinical findings suggestive of lupus erythematosus on the other. Based on our findings, it is not possible to separate LIS from the spectrum of DLE.

Antigens, CD↗

The reliability of immunofluorescence and histopathology in the diagnosis of discoid lupus erythematosus and lichen planus.

We have investigated the diagnostic reliability of the immunofluorescence (IF) technique and histopathology in discoid lupus erythematosus (DLE) and lichen planus (LP) and in diseases clinically resembling these (DLE-like and LP-like). In all cases of DLE and LP it was possible to establish the clinical diagnosis with one or both methods, when in initially negative cases the investigations were repeated on fresh biopsies. In DLE the diagnostic specificity of IF was greater than that of histopathology, and the diagnostic sensitivity of the results of both methods together was greater than that of the two methods separately. In LP the diagnostic specificity of both methods was maximal, but IF showed greater diagnostic sensitivity. These differences were not statistically significant. The most important immunohistochemical feature for diagnosis by IF was the incidence and the morphological pattern of IgG along the epidermal basement membrane. This held true for differentiation between LP and DLE and also between DLE and DLE-like diseases. Combination of the results of IF and histopathology gave the most reliable results in DLE. In LP, IF was more reliable than histopathology.

Biopsy↗

Successful treatment of discoid lupus erythematosus with argon laser.

Vascular lesions with telangiectasias on visible areas, such as the face, are common in discoid lupus erythematosus (DLE); however, an efficient management of these skin lesions can sometimes be difficult. Since argon laser light is able to specifically coagulate vascular structures, it has been used in the treatment of various vascular skin malformations. Therefore, we addressed the issue whether argon laser treatment could be a therapeutic alternative for this disease. Here, we report on a patient with DLE, who suffered from long-standing erythematous, telangiectatic plaques on the face refractory to standard regimens of therapy. After 2 laser applications, a significant improvement was observed and after 5 sessions of argon laser therapy the treated skin lesions had completely resolved with an excellent cosmetic result. The patient tolerated the laser treatment well without any short-term side effects. These data indicate that argon laser therapy might be a powerful alternative approach in the treatment of vascular skin lesions of DLE.

Argon↗

Discoid lupus erythematosus as part of a larger disease spectrum. Correlation of clinical features with laboratory findings in lupus erythematosus.

This study compares the immunologic features of a homogeneous group of patients with discoid lupus erythematosus (DLE) strictly limited to the skin (group 1) with those of patients with active discoid skin lesions plus visceral involvement (group 2) and with those of lupus erythematosus (LE) patients with proliferative glomerulonephritis (group 3). Positive antinuclear antibody (ANA) was found in 4% of group 1, 93% of group 2, and 100% of group 3. Low total hemolytic complement (CH50) was found in 4% of group 1, 47% of group 2, and 100% of group 3. Antibodies to native DNA (nDNA) were not found in group 1, were rarely found in group 2, and were present in nearly all patients in group 3. No group 1 patient had subepidermal immunoglobulin deposits in normal skin, 20% of group 2 had this finding, and 100% of group 3 had this finding. The ability to develop chronic discoid skin lesions appears to be associated with a reduced incidence of immunologic parameters of disease activity. The data suggest that patients with active discoid skin lesions rarely have severe renal disease.

Antibodies, Antinuclear↗

Anticardiolipin antibodies and antiphospholipid syndrome in chronic discoid lupus erythematosus.

Anticardiolipin antibodies (aCL) of immunoglobulin (Ig) G and M classes were determined in 28 patients affected with chronic discoid lupus erythematosus (CDLE), comparing their prevalence and levels to those in 60 healthy subjects matched for age and sex. A high and significant frequency of IgG (67.8%) and IgM (50.0%) aCL together with prevalence of high antibody levels was found in CDLE patients, while healthy controls had IgG and IgM aCL in 1.6% and 3.3% of cases respectively. Clinical features in keeping with the diagnosis of antiphospholipid syndrome were found in one patient (3.5%), which, as the first manifestation of the syndrome, showed a pulmonary thromboembolism which appeared some days after prolonged exposure to the sun. These results provide additional data on autoimmune phenomena in CDLE and suggest that aCL test should be considered as useful aids in immunological diagnosis of CDLE.

Adult↗

Oral discoid lupus erythematosus. I. The validity of previous histopathologic diagnostic criteria.

The histopathologic criteria set down by Lever for skin lesions of discoid lupus erythematosus (DLE) and the criteria for oral DLE suggested by the World Health Organization (WHO) have been tested on 136 biopsy specimens from oral lesions comprising 42 cases of clinically typical DLE, 24 cases of atypical DLE, 25 cases of lichen planus (LP), 25 cases of leukoplakia, 13 cases of indefinite diagnosis termed DLE? LP? and seven electrogalvanically- induced white lesions. Following studies of inter- and intraexaminer variation, the final recording was done in random order without the investigators knowing the clinical diagnosis in each case. The results showed that Lever's criteria had a high specificity for oral DLE as compared to LP and leukoplakia, but the sensitivity for clinically atypical oral DLE was rather low. The criteria established by the WHO showed no specificity for oral DLE as compared to LP. Neither the criteria by Lever nor the criteria of the WHO were specific for oral DLE as compared to electrogalvanically induced white lesions. Both sets contained criteria showing rather high inter- and intraexaminer variation. Therefore, there is a need to establish a set of histopathologic criteria showing high sensitivity and specificity for both clinically typical and atypical DLE, based on criteria showing a low inter- and intraexaminer variation.

Adolescent↗

[Analysis of the clinic with pathology and detection using IGSS of 201 cases of discoid lupus erythematosus]

Clinic pathology and detection using IGSS of 201 cases of discoid lupus erythematosus (DLE) were studied in this paper.The results showed:1.DLE usually occured on the low lip(60%);2.Suffering from gastrointestinal disease were the first symptom(25%DLE cases was confirmed by mild dysplasia,3 cases of carcinoma.1 cases Combined of DLE and lichen planus(LP);4.Immunogold-silver Staining (IGSS) was applied to detect immune complex.The result indicated that Fg,immunoglobins and complement C3 deposited at basal membrane zone of DLE.It is illustrated that DLE is an autoimmune disease which is caused by many kinds of factors and may be cancerous.Coexistence of DLE and LP suggested that they may be at different stages of the same disease.Its mechanism will be further studied.

Journal Article↗

Evolution of the lesion of discoid lupus erythematosus: a comparison with lichen planus.

The tissue processes leading to the development of the epidermal changes in the lesion of discoid lupus erythematosus have been studied. Typical lesions in fifteen patients have been examined using cell kinetic and immunofluorescence techniques. The results suggest that a very active repair mechanism is operative within the epidermis with heightened epidermopoiesis and epidermal cell migration. The findings have been contrasted with those of previous similar studies of lichen planus. It is suggested that a major difference between the gross and microscopic appearance in the two diseases may be partially on the basis of differing patterns of immunoprotein deposition.

Adult↗

Examination of HL-A antigens and lymphocytotoxic antibodies in discoid lupus erythematosus.

The distribution of HL-A antigens and lymphocytotoxic antibodies has been studied in the sera of patients suffering from discoid lupus erythematosus (DLE). A significant deviation in HL-A5 antigen has been found in the 33 cases investigated, while the lymphocytotoxic antibodies were present in only 8 sera. The possible cause of these findings are discussed.

Antibodies↗

[Expression of Fas and Fas ligand in lesions of patients with discoid lupus erythematosus].

OBJECTIVE: To study the relation of apoptosis and pathogenesis of lupus erythematosus. METHODS: Expressions of Fas and Fas ligand(FasL) were detected in 30 lesions of discoid lupus erythematosus(DLE) and 5 skin specimens from healthy controls by immunohistochemical staining. RESULTS: Fas and FasL were positively expressed in most epidermal keratinocytes, infiltrating lymphocytes around blood vessels and appendages, and Fas was positively expressed in a few sweat ducts and hair follicles. Fas and FasL expressions were weakly positive or negative in healthy controls. CONCLUSION: Apoptosis induced by Fas, FasL pathway may be related to the pathogenesis of lupus erythematosus.

Adult↗

A clinicopathologic study of scarring alopecia due to lichen planus: comparison with scarring alopecia in discoid lupus erythematosus and pseudopelade.

The clinicohistologic findings in 68 patients with lichen planus scarring alopecia (LP) were compared with those of 25 patients with discoid lupus erythematosus of the scalp (DLE) and 25 with pseudopelade (PP). The combination of diffuse scaling, erythema, telangiectases, and mottled hyperpigmentation within areas of scarring alopecia was a distinctive feature of DLE, whereas the clinical picture of PP was indistinguishable from that seen in 29 patients with LP. In most patients with LP, the histologic changes involved only the follicles and the perifollicular dermis. Less frequently, the inflammatory process extended to the epidermis and the papillary dermis. In all cases, histopathologic features allowed LP to be distinguished from DLE regardless of the stage of the disease. The finding of a bandlike fibrotic thickening of the papillary dermis accompanied by fibrotic tracts at sites of destroyed follicles appeared to be a hallmark of "burnt out" lesions of LP. This histologic clue may be helpful in achieving a specific diagnosis of LP in cases that fulfill the clinical criteria for PP.

Adult↗