Medical history (history of illness) represents an important component in the diagnosis of lupus erythematosus (LE). Family history
- Is there a history of frequent skin diseases, autoimmune diseases in your family?
Social history
- What is your profession?
- Is there any evidence of psychosocial stress or strain due to your family situation?
Current medical history/systemic history (somatic and psychological complaints).
- Have you noticed any skin changes? If so, in which areas? Since when?
- Do these skin changes hurt or do you notice increased sensitivity to touch?
- Do you suffer from hair loss?
- Have you noticed any abnormalities such as skin changes or ulcers around mucous membranes?
- Do you feel ill?
- Do you have/have you had a fever recently?
- Do you suffer from muscle/joint pain?
- Do you suffer from dry mucous membranes / eyes?
- General feeling of illness
- Have you noticed any unwanted weight loss?
- Do you suffer from nausea or diarrhea?
- Have you noticed lymph node enlargement?
- Do you have any joint problems?
- Arthralgia, often in the small joints.
- Do you have muscle discomfort?
- Do you have neurological complaints such as cephalgia (headache), epileptiform seizures* , psychotic states* , cognitive disturbances, acute confusion* , movement disorders* .
- Have you noticed dryness of the eyes?
Vegetative anamnesis including nutritional anamnesis.
- Do you have frequent and much exposure to the sun or artificial light sources such as solarium?
- Have you lost body weight unintentionally?
- Do you smoke? If so, how many cigarettes, cigars or pipes per day?
Self history including medication history.
- Pre-existing conditions (skin diseases)
- Operations
- Allergies
- Pregnancies
Medication history
Medications reported to be associated with lupus erythematosus:
- ACE inhibitors (antihypertensive) – captopril, enalapril, lisinopril, cilazapril.
- Antiestrogens such as anatrozole or tamoxifen.
- Beta blockers (antihypertensive) – acebutol, oxprenolol, practolol
- Biopharmaceuticals (synonyms: biopharmaceuticals, biologicals, biologics or biologics) – etanercept, efalizumab, adalimumab, infliximab.
- Bupropion (nicotine cessation medication).
- Calcium channel blockers (antihypertensive) – diltiazem, verapamil, nifedipine, nitrendipine.
- Carbamazepine (anti-epileptic).
- Quinidine
- Chloropromazine (neuroleptic)
- Docetaxel (chemotherapeutic agent)
- D-Penicillamine
- Fluorouracil (chemotherapeutic agent)
- Griseofulvin (mycotic)
- Hepatitis B vaccination – reported to be able to trigger cutaneous lupus erythematosus.
- HMG-CoA reductase inhibitors (statins) – simvastatin, pravastatin
- Hydantoin (antiepileptic) – no longer in use today.
- Hydralazine (antihypertensive)
- Hydrochlorothiazide (HTC)
- Interferon
- Isoniazid (tuberculostat)
- Live vaccines should not be used in cutaneous lupus erythematosus with immunosuppressive therapy
- Leflunomide (immunosuppressant).
- Leuprorelin – hormonal drug, which is used mainly in prostate cancer.
- Naproxen (analgesic)
- Estrogens
- Penicillamine
- Phenytoin (antiepileptic)
- Piroxicam (non-steroidal anti-inflammatory drug, NSAID).
- Procainamide (local anesthetic)
- Proton pump inhibitors – lansoprazole, pantoprazole, omeprazole.
- Reserpine (antihypertensive).
- Rifampicin (tuberculostatic drug)
- Spironolactone (potassium-sparing diuretic).
- Sulfasalazine
- Terbinafine (antifungal) → subacute cutaneous lupus erythematosus (SCLE).
- Ticlopidine hydrochloride (ADP-antagonizing platelet function inhibitor).
Köbner phenomenon
In Köbner’s phenomenon, a nonspecific skin irritation triggers the skin symptoms that already exist due to a skin disease in another part of the body. Köbner’s phenomenon can be triggered by the following skin irritations:
- Argon laser treatment
- DNCB (dinitrochlorobenzene) sensitization
- Performance of electromyography – registration of the electrical activity of the muscles can lead to the triggering of the Köbner phenomenon in lupus erythematosus profundus.
- Scratching
- Cryotherapy (cold treatment)
- Moxibustion – method from traditional Chinese medicine.
- Nickel contact dermatitis
- Surgical procedures
- Smallpox vaccination
- Radiatio (irradiation)
- Tattoo
- UVA emission of a photocopier
- Burns
- Wounds, bite injuries
