Photo gallery: connective tissue diseases

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Abstract

Connective tissue forms the basis of skin, bone, cartilage, blood, and vascular walls. Connective tissue diseases are a diverse group of autoimmune disorders that often manifest as skin lesions. Diseases are classified as localized (affecting a single type of tissue) or systemic (affecting multiple organs and target tissues). Their development may be caused by genetic predisposition, external factors (such as infectious agents, ultraviolet radiation, smoking, certain medications, stress, etc.), and changes in hormonal balance. The most common diseases associated with rashes include various variants of lupus erythematosus and dermatomyositis. Additionally, there are several features associated with the clinical presentation and location of a lesion. For example, discoid lupus erythematosus is characterized by erythematous lesions with scaling, atrophy, and scarring. These lesions are primarily found on exposed areas of the skin and scalp. Dermatomyositis is characterized by skin involvement of the trunk and limbs, periorbital lilac-coloured edema (heliotrope eruption), and Gottron papules on the hands. In systemic lupus erythematosus, skin manifestations, such as spots and papules, are often accompanied by internal organ involvement.

A comprehensive approach is required for the diagnosis of connective tissue diseases, incorporating laboratory and imaging tests. In addition to pharmacological therapy, treatment includes physical therapy, exercise, and massage to suppress disease activity and prevent complications. If conservative treatment is ineffective, surgery is required.

This photo gallery shows different types of skin lesions that are associated with connective tissue diseases.

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About the authors

Natalia P. Teplyuk

The First Sechenov Moscow State Medical University

Email: Teplyukn@gmail.com
ORCID iD: 0000-0002-5800-4800
SPIN-code: 8013-3256

MD, Dr. Sci. (Medicine), Professor

Russian Federation, Moscow

Yuliya V. Kolesova

The First Sechenov Moscow State Medical University

Author for correspondence.
Email: kolesovamsmu@gmail.com
ORCID iD: 0000-0002-3617-2555
SPIN-code: 1441-8730

MD, Cand. Sci. (Medicine)

Russian Federation, Moscow

Taisiia A. Gurianova

The First Sechenov Moscow State Medical University

Email: gurianova.123.ta@gmail.com
ORCID iD: 0009-0001-3447-3776
Russian Federation, Moscow

References

Supplementary files

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2. Fig. 1. Discoid lupus erythematosus in a 42-year-old woman: erythematous lesions with scaling on the face (a); erythematous lesions with atrophy on the shoulders of a 42-year-old woman (b); lupus manifestations on the back (c).

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3. Fig. 2. Lupus profundus (lupus panniculitis): an ulcerated nodule on the right side of the chest, a scar at the site of a healed lesion on the left side (a); a plaque on the back (b).

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4. Fig. 3. Dermatomyositis: characteristic violaceous (heliotrope) periorbital edema and erythema ― the "heliotrope rash" sign (a); Gottron's papules (b).

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5. Fig. 4. Dermatomyositis: violaceous erythematous lesions on the upper extremities, chest, and abdomen (a); manifestations on the skin of the back (b); Gottron's papules (violaceous-pink, scaly plaques on the dorsal surfaces of the hand joints) (c).

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6. Fig. 5. Polymorphic light eruption: macules on the cheeks (a); a pustule on the cheek (b); macules in the décolletage area (c); macules and plaques on the back and posterior neck (d).

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7. Fig. 6. An erythematous lesion with central atrophy in discoid lupus erythematosus.

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8. Fig. 7. Discoid lupus erythematosus involving the scalp.

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9. Fig. 8. Discoid lupus erythematosus: an area of scarring alopecia (a); scaly plaques on the skin of the posterior neck (b).

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10. Fig. 9. Discoid lupus erythematosus: plaques and spots with atrophy in the center, crusts and scales located in the peripheral part of the elements in the back area (a); fragment of the image (b); the same elements in the upper extremities (c).

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11. Fig. 10. Discoid lupus erythematosus: bright red erythematous lesions on the face (exhibiting scaling and developing atrophy).

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12. Fig. 11. Discoid lupus erythematosus on the face, shoulders, and décolletage area.

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13. Fig. 12. Discoid lupus erythematosus: violaceous-red erythema with atrophy on the face (a, b).

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14. Fig. 13. Systemic lupus erythematosus: cutaneous manifestations presenting as violaceous-pink scaly macules and plaques in the décolletage area (a), on the hands (b), on the face and neck (c).

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15. Fig. 14. Discoid lupus erythematosus: erythematous lesions with characteristic scaling and atrophy on the face (a), on the cheeks (b), on the skin of the forearm (c).

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