Quality of life and disease severity in a cutaneous lupus erythematosus pilot study.

findings into 3 groups. The first, nonspecific cutaneous signs and disorders (Table), has already been reported in association with SM exposure as late skin findings. However, owing to lack of a control group in the present descriptive study, and also the multifactorial causes of these disorders, correlation of them with exposure to SM could not be confirmed. Nonetheless, the higher incidence compared with the normal population is noteworthy. We also found SM scars, with their special pigmentary, trophic, and vascular changes, to be specific lesions somehow different from other burn scars. They were usually localized and had ill-defined borders, areas of hyperpigmentation and depigmentation beside each other (localized leukomelanoderma), reticular atrophic and hypertrophic areas with islands of normalappearing skin, and occasional cherry angiomas and telangiectasia. Finally, 9 patients in our study developed cutaneous malignant neoplasms several years after SM exposure. Since SM is an alkylating agent and DNA is one of SM’s most sensitive targets, it is not surprising that carcinogenesis and radiomimetic effects were seen. To date, the number of cutaneous cancers reported subsequent to acute and chronic SM exposure is low, and it is unclear whether some of these cutaneous neoplasms are related to the carcinogenic effects of SM or are related to the presence of chronic skin ulcers and scars. In conclusion, there maybe a causal relationship between acute and severe exposure to SM and hyperpigmentation, depigmentation, chronic skin ulceration, scar formation (with specific features of pigmentary, trophic, and vascular changes), and development of skin cancer.