Lupus is a chronic auto immune condition that affects many systems in one's body. Cutaneous lupus erythematosus is one type of lupus.
Cutaneous lupus can be divided into three main categories:
- Acute cutaneous lupus erythematosus
- Subacute cutaneous lupus erythematosus
- Chronic cutaneous lupus erythematosus
Cutaneous lupus is more common among females between 20 years old and 50 years old, and it is induced by exposure to sunlight.
There are various skin rashes associated with cutaneous lupus, but out of all discoid lupus, is the most common form of chronic cutaneous lupus erythematosus. As the name describes, the rash is a coin like shape. These rashes can appear anywhere on the body, but most commonly appears over the nose, cheeks, and the ears. However, it can also appear over the neck, upper back, and on the dorsum of the hand.
The rash that appears symmetrically on the cheeks and over the nasal bridge is known as a malar rash, or a butterfly rash.
What does the rash look like?
The features of each and every type of cutaneous lupus erythematosus will vary from one type to another.
Acute Cutaneous Lupus Erythematosus
Acute cutaneous lupus erythematosus affects about 50% of patients with SLE, and it is more common among younger females.
The features include:
- A butterfly rash on the face which can last up to a few hours or days.
- Reddish raised (popular) rash on the arms which can sometimes form large plaques which may spread to other areas of the body.
- The rash will appear on to the skin that is exposed to sun light ( i.e. photosensitive)
- Mouth ulcers may also develop in these patients.
Subacute Cutaneous Lupus Erythematosus
This may also develop in 50% of the patients suffering with a mild form of SLE.
Subacute cutaneous lupus erythematosus is precipitated by the exposure to sun. It heals centrally without leaving a scar behind.
Chronic Cutaneous Lupus Erythematosus
Chronic cutaneous lupus erythematosus is the most common form, and about 25% of patients with this condition also develop SLE.
The rash appears as a thick, red scaly patch, which is not painful or itchy. These rashes heal slowly and often leave behind a white scar.
Does cutaneous lupus affect internal organs?
Unlike systemic lupus erythematosus (SLE), cutaneous lupus does not affect internal organs. However, about 1 in 10 people with cutaneous lupus go on to develop SLE later in their life. About 16.7% of the patients with discoid lupus will progress to develop SLE within three years of a diagnosis.
How is cutaneous lupus diagnosed?
Cutaneous lupus is difficult to diagnose, as the symptoms are not always present. However, when the symptoms appear, it is often confused with other diseases with similar presentation. Therefore it can be misdiagnosed.
During your visit with a doctor, they will conduct a physical examination. They will also run some useful tests to reach accurate diagnosis.
Antibody testing is useful to diagnose the condition, but a skin biopsy is diagnostic of cutaneous lupus erythematosus.
Treatment of cutaneous lupus
The main aims of treatment for cutaneous lupus are to:
- Prevent flare-ups of the disease
- Control the symptoms
- Prevent damage to organs
Drugs that will suppress your immunity reduce the inflammation and pain, and drugs that will prevent damage to your joints will be prescribed for the treatment of cutaneous lupus.