Information From Your Health Care Provider

LUPUS ERYTHEMATOSUS, DISCOID

Basic information

description

Discoid lupus erythematosus (DLE) is a chronic skin disorder. Localized DLE (the more common form) involves the skin on the face, scalp, ears, and neck. Generalized DLE involves other areas of skin. DLE is different from systemic lupus erythematosus (SLE), which affects many different internal organs. DLE affects all ages and both sexes. It typically occurs in women in their 30s.

FREQUENT SIGNS & SYMPTOMS

Coin-shaped (discoid), red, raised, scaly skin patches (they may be referred to as rashes, plaques or lesions). Erythematosus means reddening of the skin.
The centers are lighter in color than the outside ring.
Patches may appear anywhere on the face. The cheeks and jawline are the most common sites. Some people describe them as "butterfly" rash when they appear on both sides of the nose.
Sunlight can worsen rash.
The patches may sometimes appear on the scalp with patches of hair loss.
Mucous membranes of the mouth may be affected.
The affected skin is usually not itchy or painful.
Scarring occurs as the rash heals.

causes

Unknown. Both genetic (hereditary) and environmental factors may contribute. It is thought to be an autoimmune disorder. In these disorders, the immune system by mistake attacks the body itself. It cannot be spread from one person to another.

risk increases with

Family history of DLE.

PREVENTIVE MEASURES

No specific preventive measures.

expected outcomes

Outcome is generally good. Symptoms of the disorder may come and go over years, but they are not life-threatening. Treatment can help improve the cosmetic appearance of the rash.

possible complications

Scarring of the face.
Systemic lupus erythematosus (about 5% of patients). If it does occur, it is usually not severe.

diagnosis & treatment

general measures

Your health care provider may do a physical exam and an exam of the affected skin. Medical tests may include blood studies and a skin biopsy. A biopsy involves removal of a sample of the affected skin for viewing under a microscope.
Treatment involves drug therapy and sunscreens. In some cases, laser therapy may be an option.
Sun exposure is a trigger for a flare-up. If possible, don't go outdoors between 10 AM and 2 PM, when the sun's ultraviolet light is strongest. If you can't avoid exposure to bright sunlight, wear protective clothing and maximum-protection sunscreen products.
Stop smoking and avoid secondhand smoke. It can interfere with some treatments.
Regular checkups with your health care provider are important, even when in remission.
To learn more: Lupus Foundation of America, 2000 L St., NW, Suite 710, Washington, DC 20036; (800) 558-0121; website: www.lupus.org.

medications

Steroid skin creams or ointments are usually prescribed. Follow instructions carefully about their use.
Plastic tape coated with steroid, injections of steroid into affected skin, or, rarely, oral steroids may be prescribed (with more severe symptoms).
Antimalaria drugs may be prescribed. They are taken by mouth and often help the symptoms of this disorder.
Use sunscreens for sun protection.

activity

No limits.

diet

No special diet.

notify our office if

You or a family member has symptoms of discoid lupus erythematosus.
The following occur during treatment:
- New skin symptoms.
- Swelling, redness, or pain in joints.