Aflak Rasheed, Shazia Rasul, Abdul Hameed.
Prevalence of usual and unusual skin manifestations of systemic lupus erythematosus in a tertiary care hospital.
J Pak Assoc Derma Jan ;26(2):118-22.

Objective To determine prevalence of different types of skin manifestations in SLE in our country. MethodsThe study was carried out at the Rheumatology and Immunology Department, Shaikh Zayed Hospital, Lahore. 125 patients who were diagnosed with SLE on basis of American College of Rheumatology classification criteria for SLE and also having skin manifestations were included from June 2011 till June 2015 from outdoor and inpatient departments. ResultsSLE specific skin manifestations were as follows: malar rash was seen in 83 (71.6%) patients, photosensitivity in 61 (49.12%) patients, oral ulcers in 39 (31.35%), maculopapular rashes in 29 (23.46%), discoid rash in 26 (20.7%), subacute cutaneous lupus erythematosus (SCLE) in 6 (5.18%) patients. The SLE non-specific skin manifestations included: vasculitic rash in 50 (40.0%), non-scarring alopecia in 39 (30.9%), palmar erythema in 26 (21.1%), vasculitic ulcers in 7 (4.9%), livedo reticularis in 5 (3.8%), digital gangrene in 3 (2.7%), and Raynaud’s phenomenon in 3 (2.2%) patients. Patients having SLE specific skin manifestations like malar and discoid rash were more likely to have internal organ involvement, while with those having SLE non-specific skin manifestations were seen with acute flare of disease. ANA and anti- dsDNA antibodies were positive in 92 % and 63% patients, respectively. Conclusion Skin manifestations in SLE are important disease parameters which can give important diagnostic and disease activity information. Thorough focus on dermatological aspect is very important for diagnosis and treatment in this entity.

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