Uncommon Mimickers of Systemic Lupus Erythematosus - Rheumatology Advisor

Uncommon Mimickers of Systemic Lupus Erythematosus

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  • Cutaneous Manifestations

    Many SLE mimics manifest cutaneous changes that resemble the dermatologic effects of SLE observed in 50% to 85% of patients.2,7,8 The Systemic Lupus International Collaborating Clinics classification criteria for SLE includes 4 types of cutaneous manifestations: acute or chronic cutaneous lupus, oral/nasal ulcers, and non-scarring alopecia.9 In US studies of SLE, the most common cutaneous conditions were malar rash (58%), discoid lesions (28%), photosensitivity (60%), and oral ulcers (53%).10 Additionally, subacute cutaneous lupus develops in 10% to 15% of patients with SLE.4 (test) Biopsy of a skin lesion with histopathologic study can often distinguish between SLE and other causes.2 An SLE band test typically shows deposits of immunoglobulin and complement components at the dermal-epidermal junction in patients with SLE but can also be positive in people without SLE.2 In addition, CD123 immunohistochemistry for plasmacytoid dendritic cells may help distinguish SLE from rosacea and other skin conditions.2

  • Microbial Infection

  • Type I Interferonopathies

  • Hemophagocytic Lymphohistiocytosis

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