Discoid Lupus Erythematosus

Discoid Lupus Erythematosus

l. Definition:

Discoid lupus erythematosus is a chronic skin condition characterized by inflammation and scarring type skin lesions which occur on the face, ears, scalp and at times on other body areas. These lesions develop as an inflamed growth with, scaling and a warty like appearance. The center areas may appear lighter in color surrounded by an area darker than the normal skin. When lesions occur in hairy areas such as the scalp, permanent scarring and hair loss can occur. A small percentage of patients with discoid lupus can develop disease of the internal organs which can make the person sick.

II. Workup:

If your doctor suspects that you have this condition, a skin biopsy needs to be done to confirm the diagnosis because other conditions can look like discoid lupus erythematosus.
If the skin biopsy shows discoid lupus erythematosus, then further testing may be indicated.

III. Causes:

The cause is unknown.
This condition tends to run in families.
Females outnumber males with this condition 3 to 1.
In some patients with discoid lupus erythematosus, sunlight may make the lesions come out.

IV. Course:

The lesions can cause permanent scarring and hair loss. The disease usually comes and goes. Discoid lupus will rarely go away and not come back.

V. Treatment:

Cortisone ointment applied to the skin in the involved areas will often improve the lesions and slow down their progression.
Cortisone injections into the lesions will also treat discoid lupus and usually are more effective than the ointment form of cortisone.
If the lesions are becoming unsightly and you really feel something more needs to be done, a drug named Plaquenil will often improve the condition. Patients on Plaquenil need eye exams once a year to prevent damage to the retina of the eye and periodic blood work.
Patients whose condition is sensitive to sunlight need to wear a sunscreen of SPF 15 or higher daily, and a hat while out doors.
Follow-up with the doctor is important and necessary every six months to once a year to make sure the disease is not spreading to the internal organs and to minimize scarring.

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