Lupus is an immune system disorder that causes the body’s own defensive mechanisms to attack healthy tissue. When this condition results in symptoms primarily affecting the skin, it is referred to as cutaneous lupus. There are actually several variations of this skin disease – each typified by a different cluster of symptoms. Currently, there is no cure for lupus although there are a number of medications that can be prescribed to reduce symptoms. Here is an overview of several types of skin lupus:
Discoid Lupus Erythematosus
DLE is the most frequently occurring form of cutaneous lupus. The term erythematosus refers to the reddening of the skin that is a common symptom. Scaly red patches appear on areas of the face and body that are frequently exposed to sunlight (e.g. cheeks, nose, back of hands). DLE can also spread to other areas of the body in rare circumstances. Skin that heals after an episode of this type of lupus is often temporarily hyperpigmented, permanently scarred, and thickened to resemble warts. If the discoid lesions occur on the scalp and destroy hair follicles, the hair may never grow back.
In this form of lupus, the immune system attacks the layer of fat just under the skin. The affected area (usually on the face) will be swollen and firm. The nodule may be inflamed for several months. When it resolves, what remains is a dimple or depression in the skin where the underlying tissue has been destroyed.
Subacute LE and Lupus Tumidus
These varieties of skin lupus are often triggered by sun exposure. Unlike DLE, they do not cause scarring. Subacute LE may appear as scaly bumps, ring shaped rashes, purple spots, or lumps. The affected areas of the skin do not itch. Lupus tumidus often resembles hives (patches of swollen, reddened skin).
Lupus is a condition that has a significant genetic component. If a mother has subacute LE (or if she has displayed symptoms in the past), her newborn may develop neonatal LE. This ring shaped rash usually goes away after several months. However, it is a warning sign that there may be an underlying heart problem in very rare cases. Babies who have NLE symptoms must be examined to ensure there is no congenital heart blockage.
Skin lupus is occasionally linked to circulatory problems. Chilblain lupus appears when the blood flow to the fingers is impaired. Living in a cold climate tends to exacerbate these symptoms, as does smoking. The area around the cuticles may display broken blood vessels and the fingertips may become ulcerated in extreme cases.