Title:Cutaneous Lupus Erythematosus in Children
Volume: 17
Issue: 2
Author(s): Vivian Tsang*, Alexander K.C. Leung and Joseph M. Lam
Affiliation:
- Faculty of Medicine, University of British Columbia, Vancouver, British Columbia, BC,Canada
Keywords:
Lupus erythematosus, autoimmune disease, hydroxychloroquine, photoprotection, CLE, SLE.
Abstract:
Background: The skin is commonly involved in autoimmune diseases, such as lupus
erythematous. The cutaneous lupus erythematosus (CLE) can manifest with or without systemic
symptoms. It is advantageous from a patient and healthcare system standpoint for early diagnosis
and intervention. Prevention of complications is especially important in the pediatric population.
Objective: To familiarize physicians with the clinical presentation, diagnosis, evaluation, and management
of pediatric cutaneous lupus.
Methods: The search term “cutaneous lupus” was entered into a Pubmed search. A narrow scope
was applied to the categories of “epidemiology”, “clinical diagnosis”, “investigations”, “comorbidities”,
and “treatment”. Meta-analyses, randomized controlled trials, clinical trials, observational
studies, and reviews were included. The search was restricted to English literature and children. A
descriptive, narrative synthesis of the retrieved articles was provided.
Results: A variety of innate and adaptive immune responses are being investigated to explain the
pathogenesis of CLE. There are a number of variations of cutaneous manifestations varying from
localized malar rash as in the case of ACLE lesions and papulosquamous psoriasiform lesions as in
the case of SCLE to the multiple subtypes within chronic CLE. First-line pharmacological treatments
include topicals, such as typical calcineurin inhibitors and corticosteroids, or oral agents,
such as glucocorticoids, antimalarial drugs, and hydroxychloroquine.
Conclusion: CLE is inclusive of a number of subtypes that have varying dermatological manifestations
in adult and pediatric populations. The current treatment modalities will change based on the
newly understood molecular targets. Ongoing research on the mechanisms underlying CLE is necessary
to derive new interventions for pediatric patients.
