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Discoid Lupus Erythematosus - Discoid Lupus Erythematosus information

What are Discoid Lupus Erythematosus

Discoid Lupus Erythematosus type of lupus erythematosus is a localized inflammation of the skin occurring most frequently in areas exposed to solar irradiation. Permanent hair loss and loss of pigmentation are common sequelae. Systemic lupus erythematosus is discussed in Musculoskeletal Disorders.

Clinical Findings of Discoid Lupus Erythematosus

Symptoms and Signs of Discoid Lupus Erythematosus

Symptoms are usually mild. The lesions consist of dusky red, well-localized, single or multiple plaques, 5–20 mm in diameter, usually on the face (see photograph). The scalp, external ears, and oral mucous membranes may be involved (see photograph). There is atrophy, telangiectasia, depigmentation, and follicular plugging. The lesion may be covered by dry, horny, adherent scales. On the scalp, significant hair loss may occur.

Differential Diagnosis of Discoid Lupus Erythematosus

The diagnosis is based on the clinical appearance confirmed by skin biopsy in all cases. The scales are dry and "thumbtack-like" and can thus be distinguished from those of seborrheic dermatitis and psoriasis (see photograph); (see photograph). Older lesions that have left depigmented scarring (classically in the concha of the ear) or areas of hair loss will also differentiate lupus from these diseases. Ten percent of patients with systemic lupus erythematosus have discoid skin lesions, and 5% of patients with discoid lesions have SLE. Medications (hydrochlorothiazide, calcium channel blockers) may induce chronic cutaneous lupus erythematosus with a positive Ro.

Treatment of Discoid Lupus Erythematosus

General Measures for treating Discoid Lupus Erythematosus

Protect from sunlight. Use high SPF (> 30) sunblock with UVB and UVA coverage daily. Caution: Do not use any form of radiation therapy. Avoid using drugs that are potentially photosensitizing (eg, thiazides, piroxicam) where possible.

Local Treatment of Discoid Lupus Erythematosus

The following should be tried before systemic therapy: high-potency corticosteroid creams applied each night and covered with airtight, thin, pliable plastic film (eg, Saran Wrap); Cordran tape; or ultra-high-potency corticosteroid cream or ointment applied twice daily without occlusion.

Prognosis of Discoid Lupus Erythematosus

The Discoid Lupus Erythematosus disease is persistent but not life-endangering unless systemic lupus intervenes, which is uncommon. Treatment with antimalarials is effective in perhaps 60% of cases. Although the only morbidity may be cosmetic, this can be of overwhelming significance in more darkly pigmented patients with widespread disease. Scarring alopecia can be prevented or lessened with close attention and aggressive therapy.

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