{"id":7863,"date":"2020-04-26T04:39:41","date_gmt":"2020-04-26T07:39:41","guid":{"rendered":"https:\/\/doctorhoogstra.com\/es\/patologia-del-lupus-eritematoso-discoide\/"},"modified":"2020-04-30T21:09:01","modified_gmt":"2020-05-01T00:09:01","slug":"discoid-lupus-erythematosus-pathology-2","status":"publish","type":"wiki","link":"https:\/\/doctorhoogstra.com\/en\/wiki\/patologia-del-lupus-eritematoso-discoide\/","title":{"rendered":"Pathology of discoid lupus erythematosus"},"content":{"rendered":"<p><\/p><div id=\"ez-toc-container\" class=\"ez-toc-v2_0_88 counter-hierarchy ez-toc-counter ez-toc-grey ez-toc-container-direction\">\n<div class=\"ez-toc-title-container\">\n<p class=\"ez-toc-title\" style=\"cursor:inherit\">Contents<\/p>\n<span class=\"ez-toc-title-toggle\"><a href=\"#\" class=\"ez-toc-pull-right ez-toc-btn ez-toc-btn-xs ez-toc-btn-default ez-toc-toggle\" aria-label=\"Toggle Table of Content\"><span class=\"ez-toc-js-icon-con\"><span class=\"\"><span class=\"eztoc-hide\" style=\"display:none;\">Toggle<\/span><span class=\"ez-toc-icon-toggle-span\"><svg style=\"fill: #999;color:#999\" xmlns=\"http:\/\/www.w3.org\/2000\/svg\" class=\"list-377408\" width=\"20px\" height=\"20px\" viewbox=\"0 0 24 24\" fill=\"none\"><path d=\"M6 6H4v2h2V6zm14 0H8v2h12V6zM4 11h2v2H4v-2zm16 0H8v2h12v-2zM4 16h2v2H4v-2zm16 0H8v2h12v-2z\" fill=\"currentColor\"><\/path><\/svg><svg style=\"fill: #999;color:#999\" class=\"arrow-unsorted-368013\" xmlns=\"http:\/\/www.w3.org\/2000\/svg\" width=\"10px\" height=\"10px\" viewbox=\"0 0 24 24\" version=\"1.2\" baseprofile=\"tiny\"><path d=\"M18.2 9.3l-6.2-6.3-6.2 6.3c-.2.2-.3.4-.3.7s.1.5.3.7c.2.2.4.3.7.3h11c.3 0 .5-.1.7-.3.2-.2.3-.5.3-.7s-.1-.5-.3-.7zM5.8 14.7l6.2 6.3 6.2-6.3c.2-.2.3-.5.3-.7s-.1-.5-.3-.7c-.2-.2-.4-.3-.7-.3h-11c-.3 0-.5.1-.7.3-.2.2-.3.5-.3.7s.1.5.3.7z\"\/><\/svg><\/span><\/span><\/span><\/a><\/span><\/div>\n<nav><ul class='ez-toc-list ez-toc-list-level-1 eztoc-toggle-hide-by-default' ><li class='ez-toc-page-1 ez-toc-heading-level-2'><a class=\"ez-toc-link ez-toc-heading-1\" href=\"https:\/\/doctorhoogstra.com\/en\/wiki\/patologia-del-lupus-eritematoso-discoide\/#Introduccion\" >Introduction<\/a><\/li><li class='ez-toc-page-1 ez-toc-heading-level-2'><a class=\"ez-toc-link ez-toc-heading-2\" href=\"https:\/\/doctorhoogstra.com\/en\/wiki\/patologia-del-lupus-eritematoso-discoide\/#Histologia-del-lupus-eritematoso-discoide\" >Histology of discoid lupus erythematosus<\/a><ul class='ez-toc-list-level-5' ><li class='ez-toc-heading-level-5'><ul class='ez-toc-list-level-5' ><li class='ez-toc-heading-level-5'><ul class='ez-toc-list-level-5' ><li class='ez-toc-heading-level-5'><a class=\"ez-toc-link ez-toc-heading-3\" href=\"https:\/\/doctorhoogstra.com\/en\/wiki\/patologia-del-lupus-eritematoso-discoide\/#Patologia-del-lupus-eritematoso-discoide\" >Pathology of discoid lupus erythematosus<\/a><\/li><\/ul><\/li><\/ul><\/li><\/ul><\/li><li class='ez-toc-page-1 ez-toc-heading-level-2'><a class=\"ez-toc-link ez-toc-heading-4\" href=\"https:\/\/doctorhoogstra.com\/en\/wiki\/patologia-del-lupus-eritematoso-discoide\/#Estudios-especiales-de-lupus-eritematoso-discoide\" >Special studies of discoid lupus erythematosus<\/a><\/li><li class='ez-toc-page-1 ez-toc-heading-level-2'><a class=\"ez-toc-link ez-toc-heading-5\" href=\"https:\/\/doctorhoogstra.com\/en\/wiki\/patologia-del-lupus-eritematoso-discoide\/#Diagnostico-diferencial-del-lupus-eritematoso-discoide\" >Differential diagnosis of discoid lupus erythematosus<\/a><\/li><\/ul><\/nav><\/div>\n\n<section class=\"textBlock\">\n<h2><span class=\"ez-toc-section\" id=\"Introduccion\"><\/span>Introduction<span class=\"ez-toc-section-end\"><\/span><\/h2>\n<p><span class=\"term\" data-term-id=\"65\">Discoid<\/span> Lupus erythematosus (DLE) is the most common form of <span class=\"term\" data-term-id=\"47\">cutaneous<\/span> lupus erythematosus. It is classified as <span class=\"term\" data-term-id=\"324\">located<\/span>, affecting only the skin on the neck, or <span class=\"term\" data-term-id=\"308\">generalized<\/span>, affecting above and below the neck. Risk of <span class=\"term\" data-term-id=\"380\">systemic<\/span> Lupus erythematosus is approximately 5%. Lesions are typically <span class=\"term\" data-term-id=\"319\">chronic<\/span> <span class=\"term\" data-term-id=\"385\">scaly<\/span> <span class=\"term\" data-term-id=\"368\">plates<\/span> on the face, scalp and ears. Eventually, scars occur that may be associated with <span class=\"term\" data-term-id=\"1142\">dyspigmentation<\/span> and <span class=\"term\" data-term-id=\"824\">alopecia<\/span>.<\/p>\n<h2><span class=\"ez-toc-section\" id=\"Histologia-del-lupus-eritematoso-discoide\"><\/span>\n<span class=\"term\" data-term-id=\"128\">Histology<\/span> discoid lupus erythematosus<span class=\"ez-toc-section-end\"><\/span><\/h2>\n<p>In DLE, the sections reveal the <span class=\"term\" data-term-id=\"61\">dermis<\/span> contains a <span class=\"term\" data-term-id=\"228\">perivascular<\/span> and <span class=\"term\" data-term-id=\"1625\">periadnexal<\/span> <span class=\"term\" data-term-id=\"1480\">lymphohistiocytic<\/span> <span class=\"term\" data-term-id=\"541\">infiltrate<\/span> under an interface <span class=\"term\" data-term-id=\"53\">dermatitis<\/span> (Figure 1). the <span class=\"term\" data-term-id=\"846\">epidermal<\/span> the interface activity shows the degeneracy of the <span class=\"term\" data-term-id=\"20\"><span class=\"term\" data-term-id=\"831\">basal<\/span> cap<\/span>, <span class=\"term\" data-term-id=\"1624\">apoptotic<\/span> <span class=\"term\" data-term-id=\"1069\">keratinocytes<\/span> and a marked thickening of the basement membrane (Figures 2, 3). In well-established lesions, there may be marks <span class=\"term\" data-term-id=\"107\">follicular<\/span> tamponade (Figure 4) and, sometimes, an epidermal reaction that can mimic a <span class=\"term\" data-term-id=\"270\">scaly<\/span> cell <span class=\"term\" data-term-id=\"32\">carcinoma<\/span> (<span class=\"term\" data-term-id=\"299\">warty<\/span> lupus erythematosus). There is a characteristic lymphohistiocytic infiltrate surrounding <span class=\"term\" data-term-id=\"14\">appendices<\/span> and glasses (figure 5). <span class=\"term\" data-term-id=\"370\">Statement<\/span> of <span class=\"term\" data-term-id=\"52\">dermal<\/span> <span class=\"term\" data-term-id=\"1636\">mucin<\/span> it can be impressive (figure 6).<\/p>\n<section class=\"textBlock imageLinkBlockTitle\">\n<h5 class=\"colour--primary\"><span class=\"ez-toc-section\" id=\"Patologia-del-lupus-eritematoso-discoide\"><\/span>Pathology of discoid lupus erythematosus<span class=\"ez-toc-section-end\"><\/span><\/h5>\n<\/section>\n<section class=\"imageLinkBlock\">\n<div class=\"flex\">\n<div class=\"imageLinkBlock__item__image\">\n<p>                        <img alt='dlefigure1__protectwyjqcm90zwn0il0_focusfillwzi5ncwymjisingilde5xq-8273208-8109153' src='https:\/\/doctorhoogstra.com\/wp-content\/uploads\/2020\/04\/dlefigure1__ProtectWyJQcm90ZWN0Il0_FocusFillWzI5NCwyMjIsIngiLDE5XQ-8273208.jpg'>\n<\/div>\n<p class=\"p-small\">Figure 1<\/p>\n<div class=\"imageLinkBlock__item__image\">\n<p>                        <img alt='dlefigure-2__protectwyjqcm90zwn0il0_focusfillwzi5ncwymjisingildfd-8070703-3996827' src='https:\/\/doctorhoogstra.com\/wp-content\/uploads\/2020\/04\/dlefigure-2__ProtectWyJQcm90ZWN0Il0_FocusFillWzI5NCwyMjIsIngiLDFd-8070703.jpg'>\n<\/div>\n<p class=\"p-small\">Figure 2<\/p>\n<div class=\"imageLinkBlock__item__image\">\n<p>                        <img alt='dlefigure-3__protectwyjqcm90zwn0il0_focusfillwzi5ncwymjisingildfd-2807271-6372451' src='https:\/\/doctorhoogstra.com\/wp-content\/uploads\/2020\/04\/dlefigure-3__ProtectWyJQcm90ZWN0Il0_FocusFillWzI5NCwyMjIsIngiLDFd-2807271.jpg'>\n<\/div>\n<p class=\"p-small\">figure 3<\/p>\n<div class=\"imageLinkBlock__item__image\">\n<p>                        <img alt='dlefigure-4__protectwyjqcm90zwn0il0_focusfillwzi5ncwymjisingildfd-1658440-3896186' src='https:\/\/doctorhoogstra.com\/wp-content\/uploads\/2020\/04\/dlefigure-4__ProtectWyJQcm90ZWN0Il0_FocusFillWzI5NCwyMjIsIngiLDFd-1658440.jpg'>\n<\/div>\n<p class=\"p-small\">Figure 4<\/p>\n<div class=\"imageLinkBlock__item__image\">\n<p>                        <img alt='dlefigure-5__protectwyjqcm90zwn0il0_focusfillwzi5ncwymjisingildfd-2605542-4288400' src='https:\/\/doctorhoogstra.com\/wp-content\/uploads\/2020\/04\/dlefigure-5__ProtectWyJQcm90ZWN0Il0_FocusFillWzI5NCwyMjIsIngiLDFd-2605542.jpg'>\n<\/div>\n<p class=\"p-small\">Figure 5<\/p>\n<div class=\"imageLinkBlock__item__image\">\n<p>                        <img alt='lupus-figure-6__protectwyjqcm90zwn0il0_focusfillwzi5ncwymjisingildfd-3710790-4318591' src='https:\/\/doctorhoogstra.com\/wp-content\/uploads\/2020\/04\/lupus-figure-6__ProtectWyJQcm90ZWN0Il0_FocusFillWzI5NCwyMjIsIngiLDFd-3710790.jpg'>\n<\/div>\n<p class=\"p-small\">Figure 6<\/p>\n<\/p><\/div>\n<\/section>\n<div class=\"clearfix imageLinkBlock\"><\/div>\n<div id=\"square-placement-country-holder\" class=\"country-dependent advert\">\n<div class=\"box-placement square-placement\">\n<div class=\"advert__frame\">\n<div id=\"dermnet-dermnet-mobbox\">\n<\/div><\/div><\/div><\/div>\n<h2><span class=\"ez-toc-section\" id=\"Estudios-especiales-de-lupus-eritematoso-discoide\"><\/span>Special studies of discoid lupus erythematosus<span class=\"ez-toc-section-end\"><\/span><\/h2>\n<p>The thickening of the basement membrane can be highlighted with periodic acid Schiff (PAS). Mucin may be highlighted by an alcian blue or colloidal iron stain.<\/p>\n<p><span class=\"term\" data-term-id=\"142\">Immunofluorescence<\/span> can be positive for <span class=\"term\" data-term-id=\"427\">immunoglobulin<\/span> (IgM, IgG and IgA) and <span class=\"term\" data-term-id=\"465\">complement<\/span> at the dermoepidermal junction and around <span class=\"term\" data-term-id=\"122\">hair<\/span> <span class=\"term\" data-term-id=\"1301\">follicles<\/span>. Band-shaped deposition at the dermoepidermal junction in non-lesional and non-solar <span class=\"term\" data-term-id=\"311\">exposed skin<\/span> it is associated with (but not a diagnosis of) systemic disease.<\/p>\n<h2><span class=\"ez-toc-section\" id=\"Diagnostico-diferencial-del-lupus-eritematoso-discoide\"><\/span>\n<span class=\"term\" data-term-id=\"813\">Differential diagnosis<\/span> discoid lupus erythematosus<span class=\"ez-toc-section-end\"><\/span><\/h2>\n<p>Lichen Planus: There are some overlapping characteristics including interface activity and Civatte body formation. However, the latter is usually more conspicuous in lichen planus. <span class=\"term\" data-term-id=\"188\">Mucous<\/span> Membrane lesions are particularly difficult to distinguish. Lichen planus generally lacks the deep and perianexal dermis <span class=\"term\" data-term-id=\"148\">inflammation<\/span> seen in lupus Immunofluorescence has been recommended to be helpful, but the results can be confusing. For example, an overlay <span class=\"term\" data-term-id=\"350\">syndrome<\/span> It is reported where there is positivity for both IgM colloid bodies at the dermoepidermal junction (lichen planus) and for granular IgG at the basement membrane (lupus type).<\/p>\n<p>Jessner <span class=\"term\" data-term-id=\"422\">lymphocytic<\/span> infiltrated: tumid lupus erythematosus (essentially DLE without epidermal changes) may be indistinguishable from DLE and some authorities believe that these conditions are the same entity. Mucin deposition is more consistent with DLE or tumid lupus.<\/p>\n<p><span class=\"term\" data-term-id=\"1064\">Polymorphous<\/span> light <span class=\"term\" data-term-id=\"704\">eruption<\/span> (PMLE): deep infiltrate and some epidermal changes can cause confusion between these conditions without good clinical correlation. PMLE often shows impressive dermal papillary <span class=\"term\" data-term-id=\"201\">edema<\/span> instead of the mucin seen in DLE and the thickening of the basement membrane should not generally be seen with PMLE.<\/p>\n<p>Squamous cell carcinoma <span class=\"term\" data-term-id=\"1409\">hypertrophic<\/span> lupus may appear scaly <span class=\"term\" data-term-id=\"30\">Cancer<\/span>. The infiltration and interface changes are useful features to correctly diagnose DLE. Note that squamous cell carcinoma can arise within chronic discoid lupus erythematosus.<\/p>\n<\/section>","protected":false},"excerpt":{"rendered":"<p>Introducci\u00f3n Discoido El lupus eritematoso (DLE) es la forma m\u00e1s com\u00fan de cut\u00e1neo lupus eritematoso. Se clasifica como localizado, afectando solo la piel sobre el cuello, o generalizado, afectando por&#8230;<\/p>","protected":false},"author":8,"featured_media":0,"menu_order":0,"comment_status":"closed","ping_status":"closed","template":"","format":"standard","meta":{"footnotes":""},"categories":[204],"tags":[205],"class_list":["post-7863","wiki","type-wiki","status-publish","format-standard","category-glosario-definiciones","tag-patologia"],"_links":{"self":[{"href":"https:\/\/doctorhoogstra.com\/en\/wp-json\/wp\/v2\/wiki\/7863","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/doctorhoogstra.com\/en\/wp-json\/wp\/v2\/wiki"}],"about":[{"href":"https:\/\/doctorhoogstra.com\/en\/wp-json\/wp\/v2\/types\/wiki"}],"author":[{"embeddable":true,"href":"https:\/\/doctorhoogstra.com\/en\/wp-json\/wp\/v2\/users\/8"}],"replies":[{"embeddable":true,"href":"https:\/\/doctorhoogstra.com\/en\/wp-json\/wp\/v2\/comments?post=7863"}],"version-history":[{"count":0,"href":"https:\/\/doctorhoogstra.com\/en\/wp-json\/wp\/v2\/wiki\/7863\/revisions"}],"wp:attachment":[{"href":"https:\/\/doctorhoogstra.com\/en\/wp-json\/wp\/v2\/media?parent=7863"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/doctorhoogstra.com\/en\/wp-json\/wp\/v2\/categories?post=7863"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/doctorhoogstra.com\/en\/wp-json\/wp\/v2\/tags?post=7863"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}