Discoid lupus erythematosus (DLE) is a chronic autoimmune condition that causes the body to attack its own healthy cells and tissues, resulting in skin damage. In discoid lupus, the damaging antibodies are believed to be T-lymphocyte blood cells. The damage caused by attacking antibodies commonly occurs as lesions that affect the face, scalp and ears. The lesions appear as red, inflamed patches with scaling and crusting around the edges. The center is typically lighter in color than the outer ring. Lesions that appear in areas where hair is present (such as the beard and scalp) can cause permanent scarring. Lupus is not contagious, and affects more women than men. Although there is no definitive cure for lupus, a variety of treatment options are available. DLE can be seen in individuals with systemic lupus erythematosus, but the vast majority only have skin involvement.
Common symptoms of discoid lupus include:
Lesions: Inflamed, red lesions that have a scaly or crusty appearance.
Areas of occurrence: Discoid lupus typically affects the face, ears and scalp. In rare cases, other parts of the body may be affected.
Rashes: Sun exposure can often trigger rashes and worsen other symptoms.
The exact cause of discoid lupus is unknown, but it is thought to be an autoimmune deficiency in which the body’s immune system attacks healthy cells and tissue. Factors such as sun exposure and smoking may contribute to the development of lesions.Occasionally individuals may have underlying systemic lupus.
Good skin care and sun protection is important for maintaining healthy skin. Considering sun exposure is a trigger for the development and progression of lesions, look for moisturizers that contain UV filters, which can offer additional safeguards against UV radiation. Make sure to apply these frequently and generously to adequately hydrate and protect the skin. Use gentle cleansers that are fragrance and allergen free to avoid irritating lesions.
If you spend time outdoors, it’s important to protect yourself from the sun’s damaging UV rays.
Limit sun exposure: Reducing your time in the sun is perhaps the easiest way to avoid damage to your skin caused by UV rays. When outdoors, set a time limit and seek shade when necessary. Also keep in mind that UV radiation is the strongest between the hours of 10 a.m. to 4 p.m.
Use Sunscreen: Sunscreens are an essential part of protection against the sun. Look for sunscreens that are labeled “Broad Spectrum”. They are often the most effective and offer protection against both UVA and UVB rays. Make sure to apply generously and frequently.
Cover and protect: Wrap-around sunglasses, wide-brimmed hats and clothing that covers your arms and legs, can offer extra protection against the sun’s harmful UV rays.
Look for any changes in your skin: If you notice changes in your skin, such as new growths, consult with a dermatologist immediately to determine if the symptoms may be precancerous.
Daily sunscreen use can help reduce the chances of developing lesions. Look for sunscreens that contain the following ingredients: Benzophenone, Oxybenzone, Avobenzone, Titanium Dioxide and Zinc Oxide. These are all active ingredients that are helpful in preventing sun damage.Make sure your sunscreen offers protection against both UVA and UVB rays. These will be simply labeled “broad spectrum”.
A doctor may prescribe topical treatments, such as corticosteroid creams, which are used to treat rashes and slow down the appearance of new lesions. Intralesional steroid injections are also used. Oral Hydroxychloroquine, which is normally used for malaria, is also sometimes used to treat skin and arthritis symptoms.