Different Types Of Lupus
There are different types of skin involvement in Lupus Erythematosus.
Lupus Erythematosus – Specific Skin Disease:
Discoid lesions:
These are scarring, coin-shaped lesions commonly seen in areas of skin
that are exposed to light, such as the scalp, and ears, and the central
portion of the face and nose. More rarely, your lips, mouth, and tongue
might be involved. These lesions can produce a scarring baldness, and
because they often affect your face, you may consider getting cosmetic
treatment. Only 1 in 10 to 1 in 20 of patients who are initially diagnosed
with this type of skin involvement, will eventually develop the severe
form of the disease that involves other organs in your body.
Subacute cutaneous lesions:
These are non-scarring, red and scaly lesions that are very photosensitive,
that is they get worse when they are exposed to ultraviolet light. They
tend to occur on the face in a butterfly shaped distribution or can be
more widespread on the body. Even though these lesions do not result in
scarring, their extent and color change can cause you major cosmetic concerns.
About half of the patients who are diagnosed with this type of skin involvement
will, in time, develop other organ involvement (also called systemic involvement
or systemic disease), such as arthritis conditions with their blood. Kidney
disease is unusual in patients with this type of skin disease.
Lupus Profundus:
This is a rare type of skin lupus erythematosus in which the subcutaneous
fat is involved giving rise at first to tender nodules that can leave,
in time, saucer like depressions in the skin surface. This type most commonly
affects the upper arms and trunk. Patients with this type of skin involvement
may have either systemic disease or disease limited to the skin.
Acute Lutaneous Lupus Lesions:
The malar rash or butterfly rash occurs in association with systemic
lupus erythematosus. It is seen in up to 2/3 of patients with systemic
disease and may be the presenting feature in up to 40%. It may vary in
degree from a mild redness or “rosy cheeks”, to multiple swollen red areas
or plaques.
Lupus Erythematosus – Non-Specific Skin Disease:
The following are skin changes that are noted in some patients with lupus
erytheamtosus but also occur in many patients without lupus erythematosus.
Thus having one of the conditions listed below does not mean that there
is a predisposition to developing lupus erythematosus.
Hair loss:
Up to 1/3 of patients with systemic lupus erythematosus get reversible
form of hair loss associated with flares of their systemic disease. They
may also note, that their hair is more brittle than previously and breaks
easily giving rise to shortened hair (“lupus hair”). Another form of reversible
hair loss that leaves distinct bald spots, alopecia areata, may also be
more common in patients with lupus erythematosus.
Vasculitis:
Patients with systemic lupus erythematosus may develop inflammation of
their blood vessels, this can result in varied manifestations running
a spectrum from multiple scattered red bumps, that may crust and ulcerate
to painful nodules.
Varied skin manifestations:
Raynaud’s phenomenon:
This is the blanching of the skin of the fingers and toes when exposed
to cold and may be followed by a blue or red discoloration.
Chilblains:
This is a cold induced injury that results in tender nodules and plaques
on the fingers and toes.
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