Sections View Full Chapter Figures Tables Videos Annotate Full Chapter Figures Tables Videos Supplementary Content +++ Systemic Lupus Erythematosus ++ Figure 19-1 Systemic lupus erythematosus Figures 19-1 and 19-2 illustrate cutaneous involvement of systemic lupus erythematosus (SLE) in the classic butterfly pattern on the face. This macular and intensely erythematous eruption is frequently aggravated by sun exposure and may flare with other symptoms of systemic disease. Graphic Jump LocationView Full Size||Download Slide (.ppt) ++ Figure 19-2 This autoimmune disease of unknown etiology affects almost every organ system. The most common findings in the child with SLE are fever, arthralgias, and arthritis. In addition, pleuritis, pericarditis, and central nervous system involvement are frequently seen in children with SLE. Lupus nephritis develops in the vast majority of affected children and may eventually cause renal failure. Graphic Jump LocationView Full Size||Download Slide (.ppt) ++ Figure 19-3 Systemic lupus erythematosus These figures illustrate additional cutaneous features of SLE. The lesions on the back (Fig. 19-3) and the hands (Fig. 19-4) are intensely erythematous macules and slightly edematous papules and plaques. Childhood SLE occurs most frequently during adolescence and is more common among African-Americans and among girls. Graphic Jump LocationView Full Size||Download Slide (.ppt) ++ Figure 19-4 Clinical criteria include rash (either malar or discoid), photosensitivity, oral ulcers, and disease of the joints, lungs, kidneys, and central nervous system. Graphic Jump LocationView Full Size||Download Slide (.ppt) ++ Figure 19-5 Systemic lupus erythematosus Figure 19-5 shows the temporary alopecia that is also a hallmark of SLE. The single most reliable laboratory test for SLE is antinuclear antibody which will be positive in almost every case of childhood SLE. Other laboratory criteria include leukopenia, thrombocytopenia, and the presence of antinative DNA antibodies. Graphic Jump LocationView Full Size||Download Slide (.ppt) ++ Figure 19-6 Involvement of the distal fingers is a common occurrence in children with SLE. Findings include telangiectasia of the nail folds, splinter hemorrhages, and digital infarcts as shown in Fig. 19-6. Graphic Jump LocationView Full Size||Download Slide (.ppt) +++ Systemic Lupus Erythematosus Vasculitis ++ Figure 19-7 Systemic lupus erythematosus vasculitis Cutaneous vasculitis occurs commonly in patients with SLE. The vasculitis may lead to ulceration as shown in Fig. 19-7. Graphic Jump LocationView Full Size||Download Slide (.ppt) +++ Neonatal Lupus Erythematosus ++ Figure 19-8 Neonatal lupus erythematosus This condition is primarily due to the transplacental passage mainly of anti-Ro (anti-SS-A) antibodies from mother to infant. Maternal anti-La (anti-SS-B) and anti-RNP antibodies may be implicated. The mother may herself suffer from a form of connective tissue disease or may be completely asymptomatic. Graphic Jump LocationView Full Size||Download Slide (.ppt) ++ Figure 19-9 The infants pictured in Figs. 19-8 and 19-9 were born with these atrophic and telangiectatic plaques on the face. Symmetrical involvement of ... Your Access profile is currently affiliated with [InstitutionA] and is in the process of switching affiliations to [InstitutionB]. Please select how you would like to proceed. Keep the current affiliation with [InstitutionA] and continue with the Access profile sign in process Switch affiliation to [InstitutionB] and continue with the Access profile sign in process Get Free Access Through Your Institution Learn how to see if your library subscribes to McGraw Hill Medical products. Subscribe: Institutional or Individual Sign In Error: Incorrect UserName or Password Username Error: Please enter User Name Password Error: Please enter Password Sign in Forgot Password? Forgot Username? Download the Access App: iOS | Android Sign in via OpenAthens Sign in via Shibboleth You already have access! Please proceed to your institution's subscription. Create a free profile for additional features.