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Photosensitivity in cutaneous lupus erythematosus

Wiley Online Library

Cutaneous lupus erythematosus (CLE) has traditionally been subdivided into acute, subacute and chronic forms, according to the 1981 Gilliam and Sontheimer classification 1. Further distinctions have been made regarding chronic forms, such as discoid lupus erythematosus (DLE), lupus tumidus (LET), lupus panniculitis/profundus and chilblain lupus, among others.

Population incidence measures show that approximately 4.3 per 100 000 are affected with CLE, and nearly two‐thirds of patients meeting the diagnostic criteria for systemic lupus erythematosus (SLE) will also have cutaneous manifestations of their disease. DLE remains the most common form of CLE, comprising over 75% of cases 2. While acute CLE is most frequently associated with active systemic disease, up to 17% of those presenting with DLE may eventually develop SLE 3.

For those with CLE, photosensitivity is a well‐documented symptom in which ultraviolet radiation (UVR) is a major exacerbating factor in cutaneous lesion development. This increased risk of developing lesions due to UVR results in a profound impact on work‐related disability and quality of life 4-6. Furthermore, investigations into photosensitive‐positive patients have shown correlations with worsened disease activity 7. Patient understanding of the role UVR plays in the course of their disease is of importance in taking adequate photoprotective countermeasures to prevent or reduce the extent of their cutaneous manifestations.

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