Сlinical cases of newly diagnosed systemic lupus erythematosus at the appointment with a dermatologist

Lupus erythematosus is a multisystemic connective tissue disease that has a wide range of manifestations affecting the skin and mucous membranes, joints, kidneys, heart, lungs, and central nervous system. In dermatology, cutaneous forms of lupus erythematosus can be classified into discoid, disseminated, centrifugal erythema, lupus panniculitis, subacute and chronic lupus, and systemic lupus erythematosus with damage to internal organs. It can develop as an independent disease or can be a result of progression of cutaneous forms.

The skin is the second most commonly affected organ in systemic lupus erythematosus folowing the joints, with skin manifestations observed in 80% of patients throughout the course of the disease. And in 20−30% of cases, the disease debuts with skin rash. Thus, these patients primarily present to dermatologists. Knowledge of the criteria for making a diagnosis, the clinical characteristics, in combination with performance of advanced laboratory diagnostic tests allow a dermatologist to suspect a systemic process in a timely manner and prescribe appropriate therapy.

The article presents two clinical observations of male patients with systemic lupus erythematosus, the diagnosis of which could not have been established for several years. The diagnosis in these cases met the 2019 European League Against Rheumatism (EULAR) and the American College of Rheumatology (ACR) classification criteria for systemic lupus erythematosus, confirmed by laboratory tests. Patients had a positive trend to response to therapy.