The Coexistence of Systemic Lupus Erythematosus and Psoriasis: Is It Possible?

Hendra Gunawan, Awalia Awalia, Joewono Soeroso

Abstract


Systemic lupus erythematosus (SLE) is a chronic autoimmune disease with various clinical disorders and frequent exacerbations. Psoriasis vulgaris is a common skin disorder which affect 1-3% of general populations. The pathophysiology regarding the coexistence of these diseases is not fully understood. Therapeutic challenges arise since the treatment one of these diseases may aggravate the other. We reported two cases of SLE with psoriasis vulgaris with clinical manifestations as recurrent erythroderma with photosensitivity. Improvement in clinical condition was observed after treating the patients with methylprednisolone combined with methotrexate. The coexistence SLE and psoriasis are considered very rare. The presence of this overlap syndrome may precede one another or occur simultaneously and is closely related with the presence of anti-Ro/SSA. Thus, it raises new challenge regarding its relationships, diagnosis, therapeutic, and management.

Keywords


Systemic Lupus Erythematosus; psoriasis vulgaris; psoriatic arthritis; overlap syndrome

References


Cojocaru M, Cojocaru IM, Silosi I, Doina C. Manifestations of systemic lupus erythematosus. J Clin Med. 2011;6(4):330-6.

Okon LG, Werth VP. Cutaneous lupus erythematosys: Diagnosis and treatment. Best Pract Res Clin Rheumatol. 2013;27(3):391-404.

Mutasim DF. Severe subacute cutaneous lupus erythematosus presenting with generalized erythroderma and bullae. J Am Acad Dermatol. 2003;48(2):947-9.

Pai V, Naveen K, Athanikar S, Dinesh U, Reshme P, Divyashree R. Subacute cutaneous lupus erythematosus presenting as erythroderma. Indian J Dermatol. 2014;59(6):634-8.

Avriel A, Zeller L, Flusser D, Abu Shakra M, Halevy S, Sukenik S. Coexistence of psoriatic arthritis and systemic lupus erythematosus. Israel Med Assoc J. 2007;9(2):48-9.

Lloyd P, Ryan C, Menter A. Psoriatic arthritis: An Update. Arthritis. 2012:1-7.

Dubois E. Lupus-specific skin disease. Dubois’ lupus erythematosus. 2nd Edition. In: Wallace DJ, Hahn BH, eds. Los Angeles: University of Southern California Press; 1974. p. 559-64.

Berthelot C, Nash J, Duvic M. Coexistent psoriasis and lupus erythematosus treated with alefacept. Am J Clin Dermatol. 2007;8(1):47-50.

Kuhn A, Sontheimer R, Ruzicka T. Clinical manifestations of cutaneous lupus erythematosus. cutaneous lupus erythematosus. First edition. In: Kuhn A, Lehmann P, Ruzicka T, eds. Heidelberg: Springer-Verlag Berlin. 2005.

Cuesta ML, I B. Connective tissue diseases and psoriasis. Actas Dermo-sifiliograficas. 2011;102(7):487-97.

Boehncke W, Qureshi A, Merola J, et al. Diagnosing and treating psoriatic arthritis: an update. British J Dermatol. 2014;170(1):772-86.

Aleo E, Migone S, Prono V, Barbieri F, Garlaschi G, Cimmino MA. Imaging techniques in psoriatic arthritis: Update 2012−2014 on current status and future prospects. J Rheumatol. 2015;93(1):53-6.

Pramatarov K, Tsankov N. Association of cutanous lupus erythematosus with other dermatological diseases. Cutaneous lupus erythematosus. First edition. In: Kuhn A, Lehmann P, Ruzicka T, eds. Heidelberg: Springer-Verlag Berlin; 2005.

Cozzani E, Drosera M, Gasparini G, Parodi A. Serology of lupus erythematosus: Correlation between Immunopathological features and clinical aspects. Autoimmune Diseases. 2014;1:1-13.

Silvy F, Bertin D, Bardin N, et al. Antinuclear antibodies in patients with psoriatic arthritis treated or not with biologics. PLoS ONE. 2015;10(7):e0134218.

Lopez-Longo F, Monteagudo I, Gonzalez C, Grau R, Carreno L. Systemic lupus erythematosus: clinical expression and anti-Ro/SS— A response in patients with and without lesions of subacute cutaneous lupus erythematosus. Lupus. 1997;6:32-9.

Johnson S, Schentag C, Gladman D. Autoantibodies in biological agent naive patients with psoriatic arthritis. Annals Rheum Dis. 2005;64:770-2.

Meurer M. Immunopathology of cutaneous lupus erythematosus. Cutaneous lupus erythematosus. First edition. In: Kuhn A, Lehmann P, Ruzicka T, eds. Heidelberg: Springer-Verlag Berlin; 2005.

Reich A, Marcinow K, Birula-Bialynicki R. The lupus band test in systemic lupus erythematosus patients. Ther Clin Risk Manag. 2011;7:27-32.

Balato N, Gallo L, Gaudiello F, Chiurazzi F, Ayala F. Transient and reversible thrombocytopenia in a psoriatic patient treated with etanercept. J Dermatological Treatment. 2010;21:117-8.

Mrowietz U, Kragballe K, Reich K, et al. Definition of treatment goals for moderate to severe psoriasis: a European consensus. Arch Dermatol Res. 2011;303:1-10.

Sinha A, Bagga A. Pulse steroid therapy. Indian J Ped. 2008;75(1):1057-66.


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