[Cutaneous-visceral interplay in patients with systemic lupus erythematosus]

Systemic lupus erythematosus (SLE) remains a challenging medical problem. The integral approach to the analysis of underlying pathogenetic processes allows identifying main symptom complexes of SLE and establishing relationship between skin lesions and activity of the disease. We examined 84 patients with SLE (84% women), their mean age was 42.3 +/- 2.3 yr duration of SLE 6.5 +/- 1.2 yr. The subacute and chronic SLE variants were diagnosed in 30 (36%) and 54 (64%) patients respectively. Grade 1 and 2-3 inflammatory process occurred in 53 (63%) and 31 (37%) patients respectively. Symptom complexes "systemic inflammation", "butterfly rash", "wrist petechiae", "enanthema of the oral mucous membrane", and other lesions were regarded as the markers of SLE activity. The relationship of lupus-cheilitis and facial erythema with polyserositis and pericarditis ("visceral pathology-cardiovascular lesions") requires instrumental examination of pericardium, pleural and abdominal cavities in the patients with the above skin symptoms for diagnostics of polyserositis. At the same time, the presence of teleangiectasia on the wrists (symptom complex "visceral pathology-renoparenchymatous lesions") requires thorough examination of the renal function. The presence of erythema at the major joints, mesh livedo, and Raynaud's syndrome (symptom complex "musculoskeletal disorders") implies specialized examination of the locomotor apparatus.