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Diseases
School of Medicine
University of Sumatera Utara
Lupus erythematosus
Dermatomyositis
Scleroderma
Rheumatoid arthritis
sjogrens syndrome
Mixed connective tissue disease
Eosinophilic fascitis
Lupus erythematosus
Young adult
Women: men = 2:1
Clinnical Findings :
Dull red macule with adherent scale with
follicular plugging, which heal with atrophy,
scarring and pigemantary changing,
telangiekatasis.
Side: usually above the neck. Favorite are
scalp, bridges of the nose, malar areas,
lower lips and ears
Differential diagnosis
Seborrheic dermatitis
Rosacea
Lupus vulagris
Sarcoid
Drug eruption
Treatment
Avoid exposure to sunlight, excessive
cold, to heat and trauma
Use a high SPF sun screen
Local:
potent or super potent corticosteroid
Intralesional triamsinolon acetonide 2,5 to
10 mg/ml
Systemic
Anti malarials. Hydroxychloroquine 6,5
mg/kg/day. Chloroquine 250 mg/day
Quinacrine
Systemic corticosteroid for widespread
or disfuguring lesion
Cutaneus manifestation
Butterfly facial erythemmabullous lesion
Diffuse, non scarring hair loss
Mucous membrane lesion eq
conjunctivitis, episcleritis, vaginal ulcer
Leg ulcer
Cutaneeous angiitis
Calcinosis cutis
Systemic manifestation
Arthralgia
Renal involvement
Myocarditis
CNS involvement
Vasculitis
Convulsion
Epilepsy
Retinitis
Idiopathic trombocytopenic purpura
Etiology
Genetic
Altered immune respon
Drugs such as hydralazine, procainamid,
sulfonamid, penicillin, anticonvulsan,
minocycline and isoniazid
Laboratory findings
Anemia hemolytic
Thrombocytopenia
Lymphopenia
Leukopenia
Erythrocyte sedimentation rate is
elevated
Coombs tes positif
Rgeumatoid factor positif
Immulogic findings
ANA test
LE cell test
Ds DNA
Anti SM antibody
Lupus band test
ANA pattern
Differential diagnosis
Dermtaomyositis
Toxic erytema multiforme
Acute rheumatoid fever
Drug eruption
Sjogrens syndrome
Treatment
Avoid exposure to sunlight and use a high SPF
sun screen
Antimalarial: hydroxychlotoquin or chloroquin
Corticosteroid: 1000 mg of prednisolone IV
daily for 3 days , followed bt oraal prednisone
0,5 to 1 mg/kg/dailly
Immunosuppressive therapy: azathiopreine,
methotrexate and cyclophosphamide
Scleroderma
Form of Scleroderma :
Localized scleroderma: morphea and
linear scleroderma
Systemic scleroderma: Progressive
systemic sclerosis and CREST syndrome
Morphea
Systemic scleroderma
Skin findings:
Raynauds phenomenon
Ski becomes smooth, yellowish, and
firm and shrink
Site:
face expressionless
Hands: clawllike (sslerodactily)
Internal involvement
Gastrointestinal: esophageal atony
Pulmonary fibrosis
Cardiac involvement: dyspnea,
palpitation
Renal failure
Skeletal involvement: articular pain,
swelling and inflammation
CREST
Systemic sclerosis that limited to the
hands, or somtime hands and lower
face. If it is associated with calcinosis,
Raynauds phenomena, esophageal
dysnotility, sclerodactily and
telangiectasia is called CREST syndrome
Laboratory findings
ANA test
antibodies to nuclear RNP
Differential diagnosis
Myxedema
Scleredema
scleromyxedema
Pathogenesis
Primary vascular damage
Autoimmune mechanism
Microchimerism
infection
Treatment
calcium channel blocker nifedipin 10 mg
four times daily.
Oral calcitriol
Azathioprine or cyclophosphamide
Prednisone
D-penisilamine
Low dose UVA 1