[Subacute cutaneous lupus erythematosus: clinical aspects, immunology and therapy]

Subacute cutaneous lupus erythematosus (SCLE) is a distinct subset of cutaneous lupus erythematosus which is defined by clinical and immunological characteristics. With regard to clinical expression and prognosis, SCLE assumes an intermediate position within the spectrum of LE between purely cutaneous discoid and systemic lupus erythematosus. The main clinical characteristics of SCLE are extensive papulosquamous or anular lesions and photosensitivity. The disease is frequently associated with Sjögren's syndrome and systemic symptoms, mainly arthralgia. Renal involvement is, however, rare. Circulating Ro-antibodies represent the main autoimmune phenomenon. An immunogenetic disposition to develop SCLE is evidenced by the detection of the HLA-B8, DR3-phenotype in a large proportion of patients. Drug therapy comprises primarily glucocorticosteroids and antimalarials, but retinoids have recently also proved highly effective.