Cutaneous Lupus

Cutaneous lupus represents the skin manifestations of lupus. Lupus is an autoimmune condition, where one’s own immunity develops a response against one’s own cells. Lupus can involve various organ systems and when it involves the skin it is referred to as cutaneous lupus. There are different types of cutaneous lupus, such as discoid lupus erythematosus (DLE), subacute cutaneous lupus erythematosus (SCLE), and skin manifestations of systemic lupus erythematousus (SLE).

Who gets cutaneous lupus ?

Both children and adults can get lupus of the skin. While individuals with systemic lupus can get cutaneous lupus, individuals without systemic lupus can get lupus in the skin only.

How do I know if I have it ?

Cutaneous lupus is best diagnosed by a dermatologist and in some cases a rheumatologist. It is often a pink scaly rash on sun-exposed areas, such as the face. For DLE, common areas of involvement are the face, ears, and scalp, with some evidence of scarring of the affected skin. For SCLE, common areas of involvement are the face, neck, chest and upper trunk. The “butterfly rash” is typically found in patients with SLE experiencing a flare. A biopsy may be needed to confirm the diagnosis in certain cases.

How can it be treated ?

Treatment of cutaneous lupus typically involves strict sun protection, the use of topical steroids and other topical anti-inflammatory medicines, as well as anti-malarial oral medicines, e.g. hydroxychloroquine (Plaquenil). If there is scalp involvement, steroid injections into the affected skin may be considered. For more resistant or extensive disease, stronger immunosuppressants may be needed. It is also important to screen those with cutaneous lupus for systemic manifestations of lupus, to insure that they do not also have systemic signs of lupus and other organ involvement. Lupus patients with systemic disease are usually co-managed with a rheumatologist.

When should I see a dermatologist about it ?

You should see a dermatologist for cutaneous lupus as soon as the rash appears to confirm the diagnosis and begin treatment.

Additional Resources:
Lupus Foundation of America