Dermatology · Connective Tissue Disorders in Skin (Lupus, Scleroderma)

A patient with SLE develops a photosensitive annular, erythematous, scaly rash on the chest and upper arms. ANA is positive at high titre; anti-Ro/SSA and anti-La/SSB antibodies are positive. There are no renal or CNS features. The diagnosis is:

  • A Discoid lupus erythematosus
  • B Systemic lupus erythematosus with acute malar rash
  • C Neonatal lupus erythematosus
  • D Subacute cutaneous lupus erythematosus (SCLE)
Correct answer: D. Subacute cutaneous lupus erythematosus (SCLE)

Explanation

Subacute cutaneous lupus erythematosus (SCLE) presents with photosensitive annular/polycyclic or papulosquamous plaques on sun-exposed areas (chest, back, arms), is strongly associated with anti-Ro/SSA and anti-La/SSB antibodies, and typically has mild or absent systemic involvement (distinguishing it from systemic LE). SCLE can also be drug-induced (hydrochlorothiazide, calcium channel blockers, proton pump inhibitors). DLE causes scarring discoid plaques with follicular plugging. Acute SLE malar rash spares nasolabial folds and lacks scaling/annular morphology.

Reference: Neena Khanna Illustrated Synopsis of Dermatology & STD, 6th ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

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