The most common of chronic cutaneous lupus types is discoid lupus erythematosus (DLE, often referred to as lupus discoid). Discoid lupus  is a milder form of lupus because it only affects the skin. Lupus discoid is characterized by red, scaly, inflamed, coin-shaped (discoid) lesions, which are dark on the outside and light on the inside. They are both pain and itch-free.

They show up mainly on the face but can appear on any part of the body. These lupus discoid rashes are sun sensitive and may appear or get worse after exposure to the sun. The lesions also may develop into skin cancer. When the lesions appear on the scalp, permanent hair loss may result. In addition, skin lesions may cause permanent scarring. Discoid lupus erythematosus can progress to the more serious systemic lupus erythematosus (SLE) in about 10% of discoid lupus erythematosus patients. However, these people probably had SLE to begin with but just had the symptoms of discoid lupus erythematosus at first.

There are two types of discoid lupus erythematosus. These are localized discoid lupus erythematosus and generalized discoid lupus erythematosus. In the localized type, lesions are limited to anywhere above the neck. In the generalized type, lesions can be both above and below the neck. Patients with generalized discoid lupus erythematosus have a somewhat greater chance to develop SLE.

In order to diagnose discoid lupus erythematosus, a biopsy of the lesions is necessary. This is because discoid lupus erythematosus can look like other diseases. Once this is done, a blood test may be necessary to determine if there are auto antibodies present in the blood to see if the patient actually has SLE with the primary symptom being that of discoid lupus erythematosus.

The exact discoid lupus causes are not known, but is considered an autoimmune disease. Lupus discoid may be caused by a malfunction of the immune system, which produces autoantibodies that attack normal skin. The lesions will sometimes be caused or made worse by exposure to sunlight or even smoking. Lupus discoid strikes three times more women than men and seems to have a hereditary factor.

Treatment of discoid lupus erythematosus includes cortisone ointments that are applied to lesions and injections of cortisone directly into lesions. The injections tend to work better than the ointments. Another treatment for lesions is Plaquenil. This drug is effective but it has a potential side effect of damaging the retina so yearly eye exams are mandatory. Two other drugs, Aralen and Quinacrine may be used to treat discoid lupus erythematosus but cause even more unwanted side effects than Plaquenil. Two others are Soriatane and Accutane.

Avoiding the sun, wearing sunscreen and protective clothing when outdoors, and getting a check-up every six months to a year can also treat discoid lupus erythematosus. At the check up, your doctor will test to be sure discoid lupus erythematosus has not developed into the more serious systemic form and will treat any scarring that has resulted from the disease.

Discoid lupus syndrome is chronic and has no cure. It also may progress to a more serious form. It is important to see your doctor if you suspect that you have discoid lupus erythematosus so that it can be treated. Even with treatment, there is no way of preventing discoid lupus erythematosus from becoming SLE. This is why regular check-ups are so important.

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