What is Cutaneous Lupus? (Types of Lupus Pt. 2)

 

 

As its name suggests, “cutaneous” lupus is related to the skin and can be common in patients with lupus. About two-thirds of lupus patients will develop these skin symptoms. The three types of skin lupus include chronic, subcutaneous, and acute. They appear as different forms of rashes and sores but the most dramatic difference between them seems to be their ability to leave permanent scars. 

 

  • Chronic Cutaneous Lupus also known as discoid lupus causes disk-like lesions. They are photosensitive and can worsen with increased sun exposure. These scaly and red lesions can produce permanent scarring and skin discoloration. When they appear on the scalp, they can cause permanent hair loss. Treatments include corticosteroid ointments, anti-inflammatory, anti-malarial, and immunosuppressive drugs. One of the most interesting things about discoid lupus is that it doesn’t normally occur with SLE and research shows that only about 5% of people with SLE get discoid lesions.

 

  • Acute Cutaneous Lupus is related to SLE and occurs when a patient has an active flare. These rashes are red and flat, almost like a sunburn. They usually appear on the face and  are described as malar, or “butterfly” rash, because of the area that they cover. They are non-scarring but may cause discoloration which can remain after a flare is finished. Treatment focuses on ending the active SLE flare, while some topical corticosteroids may be used to treat lesions directly.

 

  • Subacute cutaneous lupus is unique because it may or not be a sign of systemic lupus. While it can occur with SLE, it is also seen in patients with Sjogren’s Syndrome, deficiency of the second component of complement (C2d), or it can be drug-induced. The two types of subacute lesions papulosquamous and annular have also been known to be associated with other conditions as well.
    • Papulosquamous lesions appear as red, scaly patches that resemble pimples and can cover large areas of the body. They can be mistaken for psoriasis or eczema.
    • Annular lesions are flat pink circles that have a red exterior. These lesions vary widely in size and may appear anywhere on the body but rarely develop on the face. 

 

One of the biggest things to remember about all types of cutaneous lupus is the focus on prevention, healing, and improving the appearance of skin. Here are some tips on skin care:

  • Reducing triggers to prevent lupus flares. 
  • Wear protective clothing
  • Use sunscreen and minimize direct sunlight.
  • Gentle skin products and makeup can be used to conceal scars. 

 

By Nadia Bhatti

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