The most common type of chronic cutaneous
lupus erythematosus is discoid lupus erythematosus.
Discoid lupus erythematosus is a milder for of lupus
because it only affects the skin. Discoid lupus
erythematosus 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 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.
Discoid lupus erythematosus 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. Discoid lupus erythematosus
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 erythematosus 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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