In approximately 10 percent of patients, discoid lupus can
evolve into the systemic form of the disease, which can affect
almost any organ or system of the body. This cannot be predicted or
prevented. Treatment of discoid lupus will not prevent its
progression to the systemic form. Individuals who progress to the
systemic form probably had systemic lupus at the outset,
with the discoid rash as their main symptom.
Discoid Lupus Erythematosus - taken from
http://www.aocd.org
Discoid lupus erythematosus (DLE) is a chronic skin
condition of sores with inflammation and scarring favoring the face,
ears, and scalp and at times on other body areas. These lesions
develop as a red, inflamed patch with a scaling and crusty
appearance. The center areas may appear lighter in color with a rim
darker than the normal skin. When lesions occur in hairy areas such
as the beard or scalp, permanent scarring and hair loss can occur. A
small percentage of patients with discoid lupus can develop disease
of the internal organs, which can make the person sick. Children and
people with many spots are usually at more risk of this. If a doctor
suspects this condition, a skin biopsy needs to be done to confirm
the diagnosis because other conditions can look like discoid lupus
erythematosus. If the skin biopsy shows discoid lupus erythematosus,
then further blood testing may be indicated.
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The exact cause is unknown, but it is thought to be autoimmune
with the body's immune system incorrectly attacking normal skin.
This condition tends to run in families. Females outnumber males
with this condition 3 to 1. In some patients with discoid lupus
erythematosus, sunlight and cigarette smoking may make the
lesions come out.
Cortisone ointment applied to the skin in the involved areas
will often improve the lesions and slow down their progression.
Cortisone injections into the lesions will also treat discoid
lupus and usually are more effective than the ointment form of
cortisone. Alternatively, calcineurin inhibitors, pimecrolimus
cream or tacrolimus ointment may be used. Imiquimod has also
been reported to be helpful in a few patients. If the lesions
are becoming unsightly and one really feel something more needs
to be done, a drug named Plaquenil will often improve the
condition. Patients on Plaquenil need eye exams once a year to
prevent damage to the retina of the eye and periodic blood work.
Closely related drugs (Aralen, Quinacrine) may be more effective
but have more side effects. Other drugs, such as Accutane and
Soriatane, can also be used.
Patients whose condition is sensitive to sunlight need to wear a
UVA/UVB blocking sunscreen daily and a hat while out doors.
Follow-up with the doctor is important and necessary every six
months to once a year to make sure the disease is not spreading
to the internal organs and to minimize scarring.
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