Diagnóstico dermatológico del lupus eritematoso cutáneo crónico: una revisión narrativa

Abstract

Introduction

Chronic cutaneous lupus erythematosus (CCLE) represents a lupus subtype with specific dermatological manifestations, frequently associated with significant morbidity (scarring alopecia, disfigurement) and potential progression to systemic lupus erythematosus (SLE). Its diagnosis is complex due to clinical heterogeneity and overlap with other dermatoses.

Objective

To synthesize diagnostic criteria for CCLE through critical analysis of clinical, histopathological, and dermoscopic findings, emphasizing atypical subtypes (verrucous, panniculitis).

Methods

Narrative review in PubMed, Scopus, Cochrane, and SciELO using terms: “chronic cutaneous lupus erythematosus”, “dermatologic manifestations”. Included clinical studies, systematic reviews, and meta-analyses (excluded isolated case reports and animal models).

Analysis and Synthesis

CCLE variants (discoid, verrucous, panniculitis) share chronicity, photosensitivity, and destructive lesions. Clinically, they present as erythematosquamous plaques (discoid), hyperkeratotic nodules (verrucous), or lipoatrophic depressions (panniculitis). Histopathology reveals periadnexal lymphocytic infiltrate, basal membrane degeneration, and follicular plugging, leading to irreversible sequelae like scarring alopecia.

Conclusions

Integrated assessment (clinical, dermoscopy, histopathology) is essential for accurate CCLE subtyping and diagnostic precision. A need persists for standardized algorithms incorporating emerging techniques (cutaneous biomarkers). Early diagnosis prevents irreversible sequelae and informs systemic prognosis.