SLE_57dc5803c44ecc3631cdc74436ee004d

SLE_57dc5803c44ecc3631cdc74436ee004d - SYSTEMIC LUPUS...

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Unformatted text preview: SYSTEMIC LUPUS ERYTHEMATOSUS OUTLINE • Definition • Epidemiology • Pathophysiology • Classification and diagnosis • Clinical Features • Lupus related syndromes • Treatment • Prognosis DEFINITION • Inflammatory autoimmune disorder affecting multiple organ systems characterized by the production of autoantibodies directed against cell nuclei” EPIDEMIOLOGY • Prevalence influenced by age, gender, race, and genetics • Prevalence: 1:2000 • Peak incidence 14-45 years • Black > White (1:250 vs. 1:1000) • Female predominance 10:1 • HLA DR3 association, Family History • Severity is equal in male and female Etiology • Genetic (HLA DR3 association) • Abnormal immune response • Environmental • UV • Viruses • Hormones (Estrogen) PATHOPHYSIOLOGY CLINICAL FEATURES: Mucocutaneous • Malar Rash (butterfly erythema) • Discoid rash • Photosensitive rash • Subacute cutaneous LE • Livedo reticularis • Alopecia • Raynaud’s • Vasculitic ulceration • Oral ulceration • Nasal septal perforation • Nailfold capillary changes MALAR RASH • Fixed erythema, flat or raised, over the malar eminences • Tending to spare the nasolabial folds DISCOID RASH • Erythematous raised patches with adherent keratotic scaling and follicular plugging; • Atrophic scarring may occur in older lesions Alopecia Subacute Cutaneous Lupus Acute Cutaneous: Malar Rash Note Sparing of Nasolabial Folds Chronic Cutaneous:Discoid Note Scarring, Hyperpigmentation Follicular Plugging Livedo Reticularis ACR ORAL ULCERS • Oral or nasopharyngeal ulceration • Usually painless, observed by a physician SLE - VASCULOPATHY • Small vessel vasculitis • Raynaud’s phenomenon • Antiphospholipid antibody syndrome CLINICAL FEATURES: Musculoskeletal • Arthritis is NONEROSIVE , transient, symmetrical, affecting small joints, seldom deforming, less severe than RA • Most common presenting feature of SLE Jaccoud’s Arthopathy: Nonerosive, Reducible Deformities CLINICAL FEATURES: Musculoskeletal • Synovitis-90% patients, often the earliest sign • Osteoporosis • From SLE itself and therapy (usually steroids) • Osteonecrosis (avascular necrosis) • Can occur with & without history of steroid therapy CLINICAL FEATURES: Ocular...
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This note was uploaded on 09/13/2011 for the course ENG 101 taught by Professor Dr.hickenbottom during the Spring '10 term at West Liberty.

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SLE_57dc5803c44ecc3631cdc74436ee004d - SYSTEMIC LUPUS...

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