Cutaneous lupus

correlation between dermatological manifestations and systemic activity

Abstract

Morbidity Lupus erythematosus is an autoimmune pathology whose clinical spectrum ranges from isolated cutaneous manifestations to severe multivisceral systemic involvement. This study aimed to analyze the interdependence between specific and nonspecific dermatological phenotypes and systemic inflammatory activity in lupus. An integrative literature review was conducted, designed according to the PRISMA protocol guidelines, through a systematized search in the PubMed, Scopus, and SciELO databases. Following the application of rigorous eligibility criteria focused on original studies published in the last decade, nine articles were selected for qualitative synthesis. The evidence indicates that the skin acts as a sentinel organ in the disease course. A predictive risk hierarchy was observed: acute cutaneous lupus and nonspecific lesions, such as vasculitis and alopecia, are strongly associated with systemic exacerbation, reflected by high clinical scores (such as Mex- SLEDAI), anti-dsDNA positivity, and complement consumption. The subacute subtype denotes intermediate systemic activity, strongly correlated with anti-Ro/SSA antibodies and photosensitivity. Conversely, chronic presentations predominantly reflect accumulated, irreversible tissue damage, requiring clinical distinction from current inflammatory activity using validated indices like CLASI. It is concluded that the detailed characterization of the dermatological phenotype constitutes an essential clinical biomarker, indispensable for risk stratification, anticipating visceral involvement, and individualizing therapeutics in the management of lupus patients.