Lupus and Your Skin

Lupus is an autoimmune disease, a condition in which your body’s immune system attacks healthy cells. Lupus can affect many organs in your body, including your skin. The skin is affected in approximately two-thirds of people who have lupus.

Discoid lupus erythematosus (DLE) flare

WHAT IS LUPUS?

There are many types of lupus, and each type affects different parts of the body in different ways.

Systemic lupus erythematosus (SLE)

is the most common form of lupus. It may be mild or severe, and it can affect many parts of the body. People with this type of lupus experience chronic inflammation, especially of the kidneys, joints and skin.

Cutaneous lupus erythematosus (CLE)

only affects the skin, although some people who have CLE also develop SLE. There are multiple forms of CLE that affect the skin differently:

Drug-induced lupus erythematosus

is a lupus-like disease that is caused by certain prescription drugs. The symptoms are similar to those of SLE and usually improve a few months after stopping the medication that caused the condition. If you believe you are experiencing this condition, talk to your doctor; do not stop any medication without talking to your doctor first.

Neonatal lupus

is a rare disorder that affects the skin of newborns. Although it usually improves on its own, infants with this condition should be closely monitored by physicians, as they may develop a serious heart condition.

Acute cutaneous lupus erythematosus

(ACLE) flare

HOW ELSE CAN LUPUS AFFECT THE SKIN?

Sometimes lupus damages the blood vessels, and this damage is visible on the skin. A condition known as Raynaud’s phenomenon occurs in some people who have lupus. Raynaud’s phenomenon restricts blood flow, resulting in the tips of the fingers or toes turning white or blue in response to cold or stress. Some people also experience numbness, tingling or pain when they are cold or stressed.

Other signs that appear on the skin when lupus involves the blood vessels include:

CAN LUPUS AFFECT MY HAIR?

SLE may be associated with hair thinning, which usually improves when the lupus is treated.

A severe lupus flare can also result in fragile hair that breaks easily. This broken hair is called “lupus hair.”

Some people who have discoid lupus, a form of CLE, can experience hair loss when the rash forms on the scalp. If the scalp scars as the rash clears, the hair loss can be permanent. Early treatment of the rash can prevent permanent hair loss.

HOW DOES A DERMATOLOGIST TREAT SKIN AFFECTED BY LUPUS?

When lupus affects the skin or scalp, you should see a board-certified dermatologist for treatment. Treating the skin can help prevent problems such as scars and permanent hair loss.

To diagnose lupus, your dermatologist may perform a skin biopsy. The dermatologist will remove a small piece of the skin so that it can be examined under a microscope. Removing the skin is a simple procedure, which your dermatologist can perform during an office visit.

Your dermatologist may also ask you about the medicines that you take, since some medicines can cause drug-induced lupus erythematosus. Make sure your dermatologist has a list of all the medicines you take.

Treatments for skin affected by lupus may include:

Corticosteroids

This type of medicine, which is applied topically, taken orally or injected in the skin, can reduce redness and swelling. Corticosteroids can also calm an overactive immune system, which causes lupus. While this type of medication is usually safe when used as directed, most patients only use a corticosteroid for a short time or occasionally to prevent the side effects associated with long-term use. If you have a patch of skin that is very thick, your dermatologist may inject a corticosteroid directly into the patch.

Subacute cutaneous lupus erythematosus (SCLE) lesions

Topical immunomodulators

This type of medicine, which is applied to the skin, can provide treatment without the side effects associated with corticosteroids. Medications in this category include tacrolimus ointment and pimecrolimus cream.

Systemic medicine

This type of medication, which works throughout the body, can help calm an overactive immune system, which causes lupus. Medicines in this category include mycophenolate mofetil, prednisone, thalidomide, methotrexate and azathioprine, as well as antimalarial drugs and retinoids.

When rashes and sores from lupus clear, they can leave dark or light spots on your skin, or even scars. If you experience this and it bothers you, talk with a board-certified dermatologist, who can provide appropriate treatment.

HOW CAN I REDUCE LUPUS FLARE-UPS?

What causes your lupus to flare depends on many factors, including the type of lupus you have. The following tips can help you avoid serious side effects from lupus and can reduce your need for treatment.

If you have lupus, you should stay out of indoor tanning beds and protect your skin from the sun by:

If you cannot replace the bulbs, a UV light filter may help. Some people say this filter reduces the skin flares and itching that occurs when they spend hours under fluorescent lights — at work, for example.

If you cannot replace bulbs or get a UV filter, you may want to wear sunscreen and sun-protective clothing while indoors.

A board-certified dermatologist is a medical doctor who specializes in the diagnosis and medical, surgical and cosmetic treatment of skin, hair and nail conditions. To learn more about lupus or to find a dermatologist in your area, visit aad. org/lupus, or call toll-free (888) 462-DERM (3376).

All content solely developed by the American Academy of Dermatology.Copyright © by the American Academy of Dermatology and the American Academy of Dermatology Association.

Images used with permission of the American Academy of Dermatology National Library of Dermatologic Teaching Slides

American Academy of Dermatology

P.O. Box 1968, Des Plaines, Illinois 60017AAD Public Information Center: 888.462.DERM (3376) AAD Member Resource Center: 866.503.SKIN (7546) Outside the United States: 847.240.1280

Web: aad.org

Email: mrc@aad.org

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