Chronic lupus erythematosus: 104 Tunisian cases
##plugins.themes.academic_pro.article.main##
Abstract
Background : Chronic lupus erythematosus is a cutaneous form of lupus erythematosus, usually involving photoexposed areas.
Aim: The aim of our study is to evaluate the epidemio-clinical trends, therapeutic features and outcome of patients with chronic lupus erythematosus, through a Tunisian hospital series. We have tried to compare our results with those of other African and western series.
Methods: It is a retrospective study, concerning all patients with chronic lupus erythematosus, attending the Dermatology department of Charles Nicolle Hospital over an 11 years period. The patients’ age, sex, clinical features, explorations results, treatment and evolution were recorded.
Results: A total of 104 patients were included. Chronic lupus erythematosus represented 0,1 % of all the dermatitis seen over 11 years. Chronic lupus erythematosus affects young women with a ratio F/M of 1,97 and an average age of 42 years. The discoid form was the most frequent clinical shape, observed in 73 % of cases (76 patients). The face was the most frequent localization of the lesions (91%). Five patients (4.8%) presented a generalized chronic lupus erythematosus. The direct immunofluorescence in sick skin was positive in 54 % of cases. Treatment included sun avoidance and oral antimalarials drugs in the majority of cases (95%). The progression from chronic lupus erythematosus to systemic lupus erythemetosus was observed in two cases (2%).
Conclusion: Chronic lupus erythematosus is a relatively rare disorder in Tunisia, compared to other African countries, where prevalence is 7 to 10 times more frequent. As shown in our study, the most common clinical feature is the discoid form. The diagnosis can be confirmed by histopathological and direct immunofluorescence examination. Progression of chronic lupus erythematosus to systemic lupus erythematosus is possible, as observed in two of our patients.
Thus, Patients with chronic lupus erythematosus should be continually followed up.
Keywords:
Chronic lupus erythematosus, epidemio-clinical trends, therapeutic features##plugins.themes.academic_pro.article.details##
References
- Letaief H, El Euch D, Mokni M, Trojjet S, Ben Osman A. Lupus eythémateux chronique : à propos de 206 cas. Nouv Dermatol 1999; 18:34-36.
- Kharfi M, Elloumi L, Khorchani H, Goucha S, Fazaa B, Kamoun MR. Lupus eythémateux chronique .Etude épidémio_clinique. Maghreb Médical 1997; 316:29-30.
- Ogunbiyi AO, Daramola OOM, Alese OO. Prevalence of skin diseases in Ibadan, Nigeria. Int J Dermatol 2004; 43:31-36.
- Do Ango-padonou F, Yedomon HG, Foyet J. Lupus eythémateux chronique : étude épidémiologique et clinique au Bénin. Le benin Medical. 1996; 5 :50-3.
- N'Diaye B, Ball MD, Strobel M. le lupus érythémateux chronique sur peau noire. JAG 1980; 13:113-117.
- Jacyk WK, Damisah M. Discoid lupus erythemtosus in the Nigerians. Br J Dermatol 1979 ; 100 :131-135.
- Findlay GH, Lups GH. The incidence and pathogenesis of chronic discoid lupus erythematosus. An analysis of 191 consecutive cases from the Transvaal. SA Medical Journal 1967; 29:694-698.
- Le Bozec P, Le Guyadec T, Cricks B, Grossin M. Place du lupus érythémateux chronique au sein de la maladie lupique. Etude rétrospective de 136 patients. Presse Med. 1994; 23:1598-1602.
- Kyriakis KP, Michailidis C, Palamaras I, Terzoudi S, Evangelou G, Damoulaki E. Lifetime prevalence distribution of chronic discoid lupus erythematosus. J Eur Acad Dermatol Venereol 2007; 21:1108-1109.
- Lopez-Tello A, Rodriguez-Carreon AA, Jurado F et al. Association of HLA-DRB1 16 with chronic discoid lupus erythemetosus in Mexican mestizo patients. Clin Exp Dermatol 2007; 32:435-438.
- Cherif F, Mebazaa A, Mokni M, El Euch D, Azaiz MI, Dhahri AB. Childhood discoid lupus erythematosus: a Tunisian retrospective study of 16 cases. Pediatr Dermatol. 2003; 20:295- 8.
- Francès C. Manifestations cutanées des lupus éryhémateux. EMC (ElsevierMasson SAS ; Paris). Dermatologie,98-495-A-10,2008.
- Pramatarov KD. Chronic cutaneous lupus erythematosus-clinical spectrum. Clinics in Dermatology 2004; 22:113-120.
- Lo JS, Berg RE, Tomecki KJ. Treatment of discoid lupus erythemetosus. Int J Dermatol 1989; 28:497-507.
- Crickx B. traitement du lupus érythémateux discoïde. Ann Dermatol Venerol 1992; 119:517-518.
- Dieng MT, Revuz J. Retinoides et lupus érythémateux cutané. Ann Dermatol Venerol 1994; 121:271-272.
- Lagrange S, Piette JC, Roy S, Papo TH. Intérêt des immunoglobulines intraveineuses polyvalentes dans les lupus cutanés résistants. Ann Dermatol Venerol 1997; 124:1-9.