The lupus rash and associated skin disease is one of the most common lupus symptoms in women and men, appearing in approximately 2/3 of all lupus patients. A lupus rash can appear on the skin in many different forms and may or may not include additional sores (lesions).
 Diagram showing a typical lupus butterfly rash. Illustration copyright 2009 Nucleus Medical Art, Inc. All rights reserved. http://www.nucleusinc.com |
Perhaps the poster-child of all lupus disease rashes is the butterfly rash. This rash often occurs in the shape of a butterfly across the face and cheeks. Large red patches on each cheek make up the wings and the body of the butterfly is formed by the bridge of the nose. The lupus butterfly rash can range from light pink to bright red.
Most lupus rashes occur on areas of the body that are exposed to ultraviolet (UV) light either from the sun or from artificial sources. These areas are most commonly the face, ears, arms, shoulders, legs, and neck.
Most lupus patients are extremely photosensitive and their symptoms are made worse by exposure to sources of UV light. Sunscreen is a vital protectant for all lupus patients, and things like tanning beds should be avoided as they can trigger the onset of lupus flares and/or make existing lupus symptoms in women and men more severe.
What Is Lupus Skin Disease And What Type Of Lupus Rash Do I Have?
Lupus skin disease is known as cutaneous lupus erythematosus. It differs from systemic lupus erythematosus (SLE) in that it only affects the skin. SLE, on the other hand, can affect not only the skin, but also many other areas of the body including the lungs, heart, brain, kidneys, and blood.
When a rash appears, the best way to determine if it is caused by cutaneous lupus is to have a qualified dermatologist perform a biopsy on the tissue. Cutaneous lupus is found in three different forms. These are:
- Chronic cutaneous lupus erythematosus (also known as discoid lupus)
- Subacute cutaneous lupus erythematosus
- Acute cutaneous lupus erythematosus
Chronic Cutaneous Lupus
Chronic cutaneous lupus, otherwise known as discoid lupus, gets its name from the round disc-like lupus rashes and lesions that commonly form on the scalp and face. They are often extremely photosensitive and may be red, scaly, and thick, but may not hurt or even itch.
Estimates suggest approximately 10% of people with chronic cutaneous lupus will later develop systemic lupus. However, it is not yet known if chronic cutaneous lupus actually progresses to systemic lupus or if these patients already have systemic lupus and the first symptoms they experience are lupus rashes.
As time passes, discoid lesions can often lead to changes in skin pigmentation and may leave behind evidence of scarring. This usually presents itself as areas of lighter or darker pigment surrounding the lesion.
If you suffer from chronic cutaneous lupus, you may also experience hair loss from lesions forming on your scalp. Pay close attention to all discoid lesions on your body and have them checked regularly by a physician. If not monitored, discoid lesions can form cancer over a long period of time.
Subacute Cutaneous Lupus
Subacute cutaneous lesions commonly appear on the arms, neck, shoulders, and other areas of the body exposed to sunlight. They normally don’t itch or leave scars, but may lead to skin discoloration. The Lupus Foundation Of America reports subacute cutaneous lupus lesions usually “appear as areas of red scaly skin with distinct edges, or as red, ring-shaped lesions”.
Acute Cutaneous Lupus
Acute cutaneous lupus rashes are something most lupus patients are familiar with. They often occur during lupus flares when signs and symptoms of systemic lupus are active and commonly appear as malar rashes (rashes comprised of flattened areas of red skin that resembles sunburn).
The most well known malar rash is the butterfly lupus rash which appears across the cheeks and bridge of the nose. However, rashes and lesions associated with acute cutaneous lupus aren’t restricted to the face. They can also occur on other areas of the body and, like other lupus rashes, are extremely photosensitive.
Lupus Rash Treatment
The most commonly prescribed remedies for treating a lupus skin rash are corticosteroid creams and other steroid gels and ointments applied topically to the lesions. In more severe cases, doctors can inject corticosteroids directly inside the lupus skin lesions.
More recently, topical immuno-modulators have been developed which treat lupus skin disease without all the side effects of corticosteroids. These include things like tacrolimus ointment (Protopic®) and pimecrolimus cream (Elidel®). They work by suppressing the immune system in the skin and are effective against most kinds of lupus rashes.
