Clinical and Dermoscopic Features of Chronic Lupus Erythematosus Cheilitis: A Prospective Cross-Sectional Study of 35 Patients From a Tertiary Care Hospital in East India.
Sonika Garg, Madhusmitha Sethy, Vishal Thakur, Biswanath Behera, Pavithra Ayyanar, Shreya K Gowda, Anupam Dey, Amit Satpathy
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Abstract
Background: Chronic lupus erythematosus (CLE) cheilitis is a rare entity. There is limited data depicting clinical and dermoscopic aspects of CLE cheilitis. The study aimed to characterize the clinical and dermoscopic features of CLE cheilitis.
Methods: This prospective cross-sectional study included all the patients of CLE cheilitis of both genders and all age groups. A detailed description of clinical morphology and associated features was performed. Dermoscopic features were analyzed as per the International Dermoscopic Society criteria. The diagnosis was confirmed by histopathology and direct immunofluorescence test.
Results: Of 35 patients, 21 were women. The lower lip was solely involved in 68% of patients, and 28% had isolated lip involvement. Plaque morphology (48.5%) was the most common, followed by ulcero-plaque (34.2%) and atrophic plaque (11.4%). The various associated features were the obliteration of the vermilion border, the presence of peripheral gray to gray-brown pigmentation, radial white and pigment lines, and the sparing of angles of the lips. Under dermoscopic examination, hairpin (74.2%) and linear irregular (65.7%) vessels, reddish to reddish-white structureless area (91.4%), radial white lines (77.1%), and linear brown-gray pigment dots/globules (34.8%) and lines (42.8%) were commonly noted. The study had a few limitations: a small sample size and a lack of a comparison group.
Conclusion: This is the largest study characterizing clinical and dermoscopic aspects of CLE cheilitis in patients of skin color. CLE cheilitis is characterized by reddish-white to reddish-gray plaque with/without a peripheral gray rim. Radial white and pigment lines, blurring/obliteration of vermilion border, and sparing of lip angle are additional clinical clues. Dermoscopy shows a reddish to reddish-white structureless area, hairpin and linear vessels, white interlacing, radial and leaf-like lines, and brown-gray linear dots/globules and lines.
期刊介绍：
Journal of Cutaneous Medicine and Surgery (JCMS) aims to reflect the state of the art in cutaneous biology and dermatology by providing original scientific writings, as well as a complete critical review of the dermatology literature for clinicians, trainees, and academicians. JCMS endeavours to bring readers cutting edge dermatologic information in two distinct formats. Part of each issue features scholarly research and articles on issues of basic and applied science, insightful case reports, comprehensive continuing medical education, and in depth reviews, all of which provide theoretical framework for practitioners to make sound practical decisions. The evolving field of dermatology is highlighted through these articles. In addition, part of each issue is dedicated to making the most important developments in dermatology easily accessible to the clinician by presenting well-chosen, well-written, and highly organized information in a format that is interesting, clearly presented, and useful to patient care.
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