Last reviewed by Editorial Team on August 13th, 2018.
What is Cutaneous Lupus Erythematosus?
Cutaneous lupus erythematosus is a type of lupus that involves the skin. It is a skin disease that is common in people suffering from lupus and which can cause rashes or lesions on the skin particularly those that are constantly exposed to sunlight such as the face, neck, ears, arms and legs.
Cutaneous lupus erythematosus commonly affects women between the ages of 20 and 50 years and is aggravated by exposure to sunlight. Children and the elderly including the male gender may also get affected with cutaneous lupus erythematosus. It is a skin related form of lupus where lupus is defined as an autoimmune disorder that affects many systems and organs of the body. Cutaneous lupus erythematosus can affect the general population regardless of racial group.
The symptoms of cutaneous lupus erythematosus differ from one person to another and depending on the form of cutaneous lupus erythematosus that hit the patient. The onset of symptoms may develop slowly or may occur suddenly. It can also be mild or severe and the symptoms will depend on which part of the body gets affected.
The general signs and symptoms of cutaneous lupus erythematosus include the following:
- Sudden onset of fever without any cause
- Body weakness and fatigue
- Malaise or a general feeling of discomfort
- Development of skin rashes
- Increased sensitivity to sunlight
- Swelling of the lymph nodes
- Difficulty in taking a deep breath or may have pain when taking a deep breath
Cutaneous lupus erythematosus is composed of four main types where each has their own distinct characteristics. The four main types of cutaneous lupus erythematosus include the following:
Chronic cutaneous lupus or discoid lupus is the most common form of cutaneous lupus erythematosus. It is characterized by a disc-shaped or coin-shaped lesion that often develops on the scalp and face, although may sometimes appear on other parts of the body. The lesion is red in color and is scaly and thick but is painless and does not itch. The lesion will also cause scarring and discoloration overtime while the growth in the scalp causes the hair fall with hair loss that may tend to become permanent when the lesion healed. Discoid lupus is also very photosensitive that it is recommended to prevent from staying under the sun for too long and if necessary, to apply sunscreen when outdoor activities as inevitable.
Subacute lupus erythematosus appears as a non-itchy rash that often develops in the chest and upper back after constant exposure to the sun. It is characterized by ring-shaped lesion with scaly skin and distinct edges. Subacute lupus erythematosus is also highly photosensitive that extra precaution is necessary when going under the sun or staying under the fluorescent light and it is also advisable to avoid staying under the sun for too long.
Acute cutaneous lupus erythematosus occurs when the systemic lupus is highly active. This type of cutaneous lupus erythematosus is characterized by a malar rash that is flattened with reddish color scattered on the face similar to sunburn. The lesion is later referred to as a butterfly rash when the rash develops on both cheeks across the bridge of the nose. Acute cutaneous lupus erythematosus is likely to be highly photosensitive and may also develop in other parts of the body such as in the arms and legs although it does not leave a scar when it healed although skin discoloration may happen.
Neonatal lupus erythematosus occurs in newborn babies from a mother suffering from subacute lupus erythematosus. The rash in this type of cutaneous lupus erythematosus appears as ring-like or annular rash which often clears after several months.
Lupus tumidus is characterized by patches that are reddish and swollen and bumps like those of urticaria. The lesion may also be ring-like or annular and which likely to clear during the winter months although it does not leave any scar after it has healed.
Cutaneous lupus mucinosis is the rare type of cutaneous lupus erythematosus. This type is characterized by small bumps and plaques and larger bumps that grow on the cheeks, upper arms, chest and upper back.
Drug-induced lupus erythematosus is caused by some medications although the symptoms take several months before it develops. The drugs implicated in the onset cutaneous lupus erythematosus are the likes of Carbamazepine, Phenytoin, Lithium, Hydralazine and Sulphonamides.
Lupus profundus is also called lupus panniculitis and affects the fat that underlies the skin. This type of cutaneous lupus erythematosus occurs at any age and can affect children. It commonly develops on the face and often causes firm and deep nodules for several months as a result of inflammation of the fat. It also leaves an unsightly sight which is of dented scars as it heals due to the fat cells that are completely obliterated by the lupus.
The exact cause of cutaneous lupus erythematosus is still unclear. It is believed to have originated from lupus that involves the skin and which is an immune disorder where the immune system attacks the healthy tissues of the body. The cause of cutaneous lupus erythematosus on the other hand is believed to be triggered by a multitude of factors that triggered the onset.
Prolonged and constant exposure under the sun is one factor believed to be the common trigger of cutaneous lupus erythematosus. The exposure may directly result in the development of the lesions or may generate the internal response in individuals highly susceptible of the disease.
Medications are also considered to be a factor that can trigger the onset of cutaneous lupus erythematosus.
Cutaneous lupus erythematosus has no cure and is considered a chronic disease that can be managed by an assortment of medications and lifestyle changes. The aim of treatment on the other hand is to prevent scarring and to improve the appearance of the patient brought by the development of lesions.
Immune suppressant drugs are commonly prescribed and are particularly beneficial in severe cases of cutaneous lupus erythematosus. Non-steroidal anti-inflammatory drugs can help in reducing the inflammation and fever. Other drugs used for the treatment of cutaneous lupus erythematosus may include the likes of corticosteroid and anti-malarial drugs.
Avoiding constant and prolonged exposure under the sun is the most recommended since sunlight triggers the onset of the lesion. Cessation of smoking is also advice while it is also necessary to immediately stop the medication that causes the lesion.