Lupus is a complex autoimmune disease in which the immune system attacks various organs and systems of the body. According to the University of Maryland Medical Center, about 75 percent of people with lupus develop symptoms involving the skin. For some, the skin disease is the only symptom of lupus, while for others the lupus is systemic and skin disease is one symptom of many.
Types
Discoid lupus erythematosus, also known as chronic cutaneous lupus, presents as round, raised, scaly lesions that often leave scars when they heal. These often worsen in sunlight. Most people with this type of lupus develop no other symptoms, but about 10 percent may also have systemic lupus, according to the Lupus Foundation of America. Subacute cutaneous lupus erythematosus, or SCLE, is a photosensitive type of lupus, creating rashes and nonscarring round lesions in response to sunlight exposure. In people with systemic lupus, a form of skin disease called acute cutaneous lupus may occur in which skin lesions and rashes develop as a result of the lupus affecting the entire body. These often look like sunburn, are worsened by sun and don't leave scars.
Diagnosis
Because the skin problems caused by lupus may look similar to many other skin conditions, diagnosis is sometimes difficult. Frequently, the doctor will perform a skin biopsy to determine the presence of lupus and try to narrow down the specific type. To diagnose systemic lupus, antibody tests are often used. These tests look for antinuclear antibodies, immune system components that attack the cell nucleus, or for antibodies specific to particular varieties of lupus. Blood tests are another option for determining the presence and type of lupus.
Treatment
A doctor may prescribe topical treatments for the skin rashes and lesions caused by lupus. Corticosteroids are available in creams, lotions, gels and sprays. Calcineurin inhibitors, available in cream and ointment forms, are another option. For stubborn cases of lupus skin disease, corticosteroid injections may help. Antimalarial drugs, such as hydroxychloroquine and quinacrine, can also be used to treat lupus of the skin. Other options include retinoids and sulfones.
Prevention
Since 40 to 70 percent of people with systemic lupus have a photosensitive reaction of the skin, according to the Lupus Foundation, protecting the skin from sunlight is a major concern. Lupus patients should stay indoors between 10 a.m. and 4 p.m., when the sun is highest in the sky. Sunscreen and protective clothing should be worn year round.
Other Symptoms
Many cases of the skin disease lupus are actually part of a more widespread condition affecting the entire body. Joint pain is a common symptom that frequently occurs alongside lupus-derived skin conditions. Some people also develop fever, ulcers in the nose or mouth, anemia and problems with organs such as the kidneys. Sometimes, cutaneous lupus is diagnosed first and then discovered later to have a systemic component, so anyone with signs of the skin disease should pay attention to the rest of the body to catch any possible signs that the disease might be systemic.
