LUPUS ERYTHEMATOSUS, DISCOID

General Information

DEFINITION--A chronic skin disorder. Localized DLE, the more common form, involves the skin on the face, scalp, ears and neck. Generalized DLE involves the skin on the arms and chest. DLE is different from systemic lupus erythematosus, a connective-tissue disease that affects many different organs. Discoid lupus progresses to systemic lupus in about 1 in 20 persons.

BODY PARTS INVOLVED--Skin.

SEX OR AGE MOST AFFECTED--Adults of both sexes. The peak incidence occurs in women in their late 20s.

SIGNS & SYMPTOMS--

Plaques (red, raised skin lesions) with the following characteristics:

• Plaques are 1cm to 4cm in diameter and have clearly defined borders.
• They may appear anywhere on the face, but the cheeks and jawline are the most common sites. Some people describe them as "butterfly" lesions when two lesions of unequal size appear on both sides of the nose.
• Lesions sometimes appear on the scalp with localized patches of hair loss.
• Lesions scar as they heal.

CAUSES--Unknown, but probably an autoimmune disorder.

RISK INCREASES WITH--Exposure to sunlight.

HOW TO PREVENT--No specific preventive measures. Protection from sunlight decreases the severity.

What To Expect

DIAGNOSTIC MEASURES--

• Your own observation of symptoms.
• Medical history and physical exam by a doctor.
• Laboratory blood studies and biopsy of skin lesions to rule out systemic lupus erythematosus.

APPROPRIATE HEALTH CARE

• Self-care after diagnosis.
• Doctor's treatment.

POSSIBLE COMPLICATIONS

• Extensive scarring of the face.
• Systemic lupus erythematosus (1-5% of patients).

PROBABLE OUTCOME--This disorder is characterized by remissions and flare-ups. It runs its course in 10 to 20 years. 95% of patients (those who don't progress to systemic lupus) live a normal life-span.

How To Treat

GENERAL MEASURES--

• Don't go outdoors between 10 a.m. and 2 p.m., when the sun's ultraviolet light is strongest. If you can't avoid exposure to bright sunlight, wear protective clothing and maximum-protection sunscreen products. Avoid fluorescent lighting, if possible.
• See your doctor for regular checkups, even when in remission.
• See Resources for Additional Information.

MEDICATION--Your doctor may prescribe:

• Injections of triamcinolone into lesions or hydroxychloroquine by mouth to shrink lesions.
• Topical steroids (occasionally) to decrease redness of lesions.

ACTIVITY--No restrictions.

DIET--No special diet.

Call Your Doctor If

• You have symptoms of discoid lupus erythematosus.
• The following occurs during treatment: Lesions on the hands. Swelling, redness, pain in joints.