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A chronic and potentially fatal autoimmune (antinuclear antibodies) disease characterized by unpredictable exacerbation and remission of inflammatory multisystemic disorder of connective tissue. The circulation of immune complexes and activation of the complement leads to involvement of the skin, joints, kidneys, serosal membranes, lungs, gastrointestinal tract, and heart.

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Systemic lupus erythematosus
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A young girl with severe cutaneous manifestation of systemic lupus erythematosus.

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There are four types of lupus erythematous.

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Systemic Lupus Erythematosus type I (Discoid or Cutaneous Lupus) affects only the skin. Round skin lesions may be scaly, raised, violet, or red occur. The distribution of the skin lesions is mainly the face, neck, scalp, ears, arms, and sometimes the chest. The skin manifestation is often worse when the person is exposed to sunlight. Most people affected with this type of lupus do not present systemic symptomatology. Cutaneous lupus is sometimes confused with psoriasis.

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Systemic Lupus Erythematosus type II (Subacute Cutaneous Lupus): This type of lupus often causes a more widespread skin rash than type I. The skin lesion begins as small, reddened, raised areas that turn into raised, scaly patches or ringlike patches. The shoulders, forearms, neck, and upper torso are most likely to be affected. This form of lupus does not cause scarring or thinning of the skin. Individuals affected with this type present with systemic symptoms involving muscle or joint pain, fatigue, or low-grade fever.

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Systemic Lupus Erythematosus type III (Drug-Induced Lupus and possible drug triggers of systemic lupus): Medications can cause temporary symptoms and signs of lupus. Most often, the symptoms disappear when the medication is stopped, generally within a few weeks. Symptoms are usually milder than in classical lupus, and the kidneys and central nervous system (CNS) are rarely affected. Most often, the administration of medication for the control of seizure in children may cause a lupus-like condition similar the type seen in adults. Medications that have been associated with drug-induced lupus include those shown in Table S-3.

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Table S-3 Medications Associated with Drug-Induced Lupus
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Neonatal Lupus Erythematosus: A rare condition presenting in infants born to mothers who have lupus. The skin lesions develop when the neonate is exposed to ultraviolet light. It usually clears up within 6 months.

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The disorder is three times more common in African American blacks than in American whites. It is also more common in Asians and in China alone, it may be more common than rheumatoid arthritis. The ethnic group at greatest risk is African Caribbean blacks. The ...

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