Preface

Lupus erythematosus (LE) is a chronic inflammatory autoimmune disease characterized by a wide spectrum of manifestations and a variable evolution. The skin is one of the most frequent sites of involvement, and thus it has long been central to the conceptual framework that physicians have used to deal with this disease. During the past few decades, the mechanisms of cutaneous LE have been under active investigation, and many clinicians and scientists around the world have spent considerable time studying the cutaneous manifestations of this disease. This research has led to the identification of subsets of LE defined by constellations of clinical and photobio-logical features, histologic and immunopathologic changes, and laboratory abnormalities. Besides the classic forms such as subacute cutaneous LE and discoid LE, there are uncommon variants that often lead to diagnostic difficulties. Therefore, there has long been a need for a book on the cutaneous manifestations of LE that provides not only a comprehensive description of the great variety of cutaneous abnormalities but also a synthesis of our knowledge of the relationship between cutaneous and systemic changes. Furthermore, the cutaneous manifestations of this disease are a reflection of very specific and also nonspecific immunopathologic events along with inflammatory responses, and major progress has been made in recent years in our knowledge of the skin as an immunologic organ. Many advances have also been made in understanding the induction of skin lesions of LE by ultraviolet light combined with alterations in selectins and adhesion molecules contributing to the accumulation of inflammatory cells in this disease. Animal models of LE have further provided insight into the contributing roles of various T-cell subsets. In addition, the management of cutaneous manifestations of LE is challenging, and although conventional topical and systemic therapy exists new treatment options have been introduced for patients with resistant disease.

Cutaneous Lupus Erythematosus is written by leading clinicians and scientists in a multidisciplinary effort and includes chapters on the clinical aspects, pathologic characteristics, and management of this disease. The combination of the latest clinical and scientific data supplemented with colour reproductions of the clinical and pathologic changes of the skin provides a comprehensive summary of information on cutaneous LE. This book acquaints dermatologists, rheumatologists, and general physicians with the skin manifestations of LE, and we further hope that Cutaneous Lupus Erythematosus will be a valuable resource for all clinicians who diagnose, treat, and manage patients with this disease. The editors would like to thank all authors for their significant contribution to accomplish this book. In addition, the editors dedicate this book to the memory of their mentor, colleague, and friend Dr. Günther

Goerz, Professor of Dermatology, University of Düsseldorf, Germany, who taught them that LE is exciting, complex, and worth spending a lifetime studying.

Düsseldorf and Wuppertal, Germany Annegret Kuhn

June 2004 Percy Lehmann

Thomas Ruzicka

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