LÚPUS ERITEMATOSO CUTÂNEO - CORRELAÇÃO CLÍNICOPATOLÓGICA DE MANIFESTAÇÕES CUTÂNEAS ESPECÍFICAS
Resumo
Introdução: O lúpus eritematoso (LE) é uma patologia multiorgânica autoimune que afeta sobretudo mulheres em idade fértil. A pele é o segundo órgão mais frequentemente atingido, depois das articulações, e pode preceder o envolvimento sistémico.
Objetivos: Apresentar aspetos clínicos que evocam a hipótese de manifestações cutâneas específicas de LE e achados histopatológicos que podem contribuir para fundamentar o diagnóstico.
Métodos: Estudo de casos com manifestações cutâneas sugestivas de LE, nos quais a correlação clínico-histopatológica possibilitou o diagnóstico de diferentes subtipos de LE.
Resultados: A correlação das alterações clínicas e histopatológicas, no contexto analítico apropriado, permitiu identificar casos concretos de manifestações cutâneas específicas de LE: 1) agudo; 2) subagudo (formas anular e papular-escamosa); 2.1) subagudo induzido por fármacos; 3) crónico, nomeadamente 3.1) discóide clássico (face e couro cabeludo); 3.2) túmido; 3.3) paniculite.
Descreve-se, adicionalmente, os achados clínicos e histopatológicos expectáveis em outras manifestações cutâneas específicas de LE.
Conclusão: O LE exibe grande variabilidade de manifestações cutâneas. A histopatologia é essencial para o diagnóstico, sendo muito importante a preservação e manuseamento apropriado do material de biópsia. A imunofluorescência direta é útil para melhorar a acuidade diagnóstica. O diagnóstico preciso, baseado na correlação clínico-patológica sistemática e integrado no contexto clínico-analítico adequado, é fundamental para o prognóstico e orientação terapêutica dos doentes.
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