Cutaneous manifestations in systemic lupus erythematosus patients attending a tertiary hospital in Nigeria

Abstract

Background: Systemic Lupus Erythematosus (SLE) is a systemic autoimmune connective tissue disorder. The clinical presentation is protean and it affects the skin, joints and other internal organs. The American College of Rheumatology criteria for diagnosis has four cutaneous signs out of the eleven. SLE can be diagnosed in patients who present with only skin features, in the presence of a serological marker according to the Systemic Lupus International Collaborating Clinics (SLICC) criteria.

Objective: This study aimed to document the cutaneous findings in SLE patients who presented at the Lagos University Teaching Hospital (LUTH).

Methods: This was a retrospective study of SLE patients who presented to the Rheumatology/Dermatology clinics of LUTH. Data was obtained from the clinic register and patients’ case record files.

Results: Systemic lupus erythematosus was diagnosed in 90 (23.9%) of the 377 patients with rheumatologic conditions. Fifty (55.6%) of these patients had cutaneous lesions. Twenty eight patients (48.9%) had acute cutaneous LE, 10 (21.3%) had sub-acute cutaneous LE; while 14 (29.8%) had chronic cutaneous LE. There was a female preponderance with the male to female ratio of 1: 14.7. The mean age of presentation was 33.5 + 14.3 (range was 9 - 68 years). The mean duration of symptoms was 28.4 ± 38.8 months. Other cutaneous lesions were alopecia, photosensitivity, oral ulcers and malar rash.

Conclusions: Skin lesions are common presentation of SLE, yielding valuable diagnostic information essential for early diagnosis, prompt management, and reduction in frequency of flares and complications.

Keywords: Lupus, Connective tissue diseases, Cutaneous clues to systemic diseases