Celebrity Health

Understanding Seal's Lupus: What Is Discoid Lupus Erythematosus?

Everyone was curious about Seal's scars when he first became a singer. Learn more about the form of lupus that caused them.

Understanding Seal's Lupus: What Is Discoid Lupus Erythematosus?

Photo: Seal by taguro izumo final (Flickr)

When Seal first emerged on the music scene he did so with an air of mystery. Who was this tall handsome singer with obvious scars on his face?  How did he get them?  For many years, rumors spread like wildfire about his trademark poked cheeks. Some were plausible, like the scars were likely caused by severe acne as a teenager. Others were a little harder to swallow, like the scars were from a tribal sacrificial rite.

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However, the truth is that Seal suffered from a form of lupus that caused the scars. Discoid lupus erythematosus (DLE) is a form of lupus that targets the skin above the neck. Typically, the disease attacks young people, such as teenagers and young adults. Seal developed the disease as a teenager and by the time he was 23, he developed irreversible scarring. DLE causes intense inflammation in the skin. Areas that are exposed to the sun are at most risk. The disease typically causes lesions to appear on the face, ears, and scalp and at times other body parts. Skin biopsies are performed after the lesions appear to get an accurate diagnosis. The disease can affect hair growth when it attacks the scalp, and as a result, patients like Seal are often bald.

As it is with other forms of lupus, there is no cure for DLE and treatment options are limited to cortisone ointments and shots designed to improve the appearance of scars after the lesions have appeared. Those who do not seek treatment or do not have it offered to them often have to deal with significant scarring like Seal’s. 

Once diagnosed with DLE the patient must be mindful to prevent a flare-up by taking great care with sun protection. This means slathering on the sunscreen, always wearing a hat and whenever possible, stay in the shade.

Facts about DLE:

  • The chronic skin condition is recognizable by the coin-shaped lesions that appear on the face, ears, and scalp. Before permanent scarring appears, the lesions have a crusty appearance and will appear lighter in the middle.
  • There are three different type of DLE
    • Localized discoid lupus erythematosus typically presents itself with lesions that are localized to the skin above the neck. The disease tends to target the bridge of the nose, cheeks, and scalp. This is the form of DLE that Seal suffers from.
    • Generalized discoid lupus erythematosus has a varying degree of severity and typically presents itself by lesions appearing around the thorax and upper arms with a few making their way to the head and neck.
    • Childhood discoid lupus erythematosus, for the most part, presents itself like the other two forms of DLE, but mostly affects males.  When a child is diagnosed with this form of DLE they are also more likely to develop the more common form of lupus called systemic lupus erythematosus (SLE).

What causes DLE?

When it comes to lupus this is the age-old question. What causes the disease?  The truth is that no one really knows.  What they do know is that something triggers the body’s immune system to attack various parts of the body. In Seal’s case, his lupus, DLE, attacked the skin on his face.

Medical experts have been able to find a few leads into the cause, which will eventually lead to a cure for the disease. They know that viruses, environmental chemicals, and genetics play a significant role in the development of the disease.

Hormones, particularly female hormones, also seem to play a part in the development of some forms of lupus. This would explain why there are such a higher number of child-bearing age women with the disease than there are men.

Who gets lupus?

Research has also helped to paint a picture of who is more likely to develop the disease.  Out of the 1.5 million people in the US with lupus, those of African, Asian and Native American descent are the most affected by the disease. The disease does affect men, but as many as 90% of those who have the disorder are women. 

What are the most common symptoms of lupus?

Since there are a number of different kinds of lupus, there are a number of symptoms that need to be factored in when searching for a diagnosis.  Those include:

  • Extreme bone-crushing fatigue
  • Painful swollen joints
  • Skin rashes, particularly across the bridge of the nose and on the cheeks. 

When not treated, lupus can lead to a number of other chronic, painful and often dangerous issues such as:

  • Arthritis
  • Kidney failure - leading to dialysis and eventual transplant.
  • Heart and lung inflammation
  • Blood disorders

What happens after a lupus diagnosis?

At the moment, there is no cure for the disease. Treatment options offered to patients are designed to help cope with the disease by lowering the risk of flare-ups and managing pain. After receiving a diagnosis of lupus, the patient should take the following steps:

  • Ask questions, research and learn about the disease.
  • It may not always be a pleasant thought, but maintaining low-impact exercises can prevent muscles from becoming weak and the development of osteoporosis.
  • Lupus patients will suddenly find themselves needing sleep a lot more. Make sure to carve time in the day for plenty of rest. The more overtired a patient is the more likely they will develop a lupus flare-up.
  • Maintain a healthy diet. As tempting as those fast-food treats may be, an unhealthy diet can lead to a flare-up and cause damage to the liver.
  • Avoid direct sun. Being outside on a warm sunny day can feel like it can cure anything, but for a lupus patient, it can actually cause them to get sick. Being exposed to the sun can cause a flare-up, leading to permanent damage to vital organs. Lupus patients should always be sun ready with sunscreen, hats, covered skin and hopefully a shady spot to rest in. 

It’s impossible to predict who is going to develop lupus or when the disease will strike. Learning to live with the chronic disorder is vital to making sure that the patient and their families live a full life.