Discoid lupus erythematosus
Discoid lupus erythematosus (Discoid lupus erythematosus) is a disease in which
coin-shaped (discoid) red bumps appear on the skin.
Description of Discoid lupus erythematosus
The disease called discoid lupus erythematosus only affects the skin, although similar discoid skin lesions can occur in the serious disease called systemic lupus erythematosus (SLE). Only about 10% of all patients with Discoid lupus erythematosus will go on to develop the multi-organ disease SLE.
The tendency to develop Discoid lupus erythematosus seems to run in families. Although men or women of any age can develop Discoid lupus erythematosus, it occurs in women three times more frequently than in men. The typical Discoid lupus erythematosus patient is a woman in her 30s.
Symptoms of Discoid lupus erythematosus
The cause of Discoid lupus erythematosus is unknown. It is thought that Discoid lupus erythematosus (like SLE) may be an autoimmune disorder. Autoimmune disorders are those that occur when cells of the immune system are misdirected against the body. Normally, immune cells work to recognize and help destroy foreign invaders like bacteria, viruses, and fungi. In autoimmune disorders, these cells mistakenly recognize various tissues of the body as foreign invaders, and attack and destroy these tissues. In SLE, the misdirected immune cells are antibodies. In Discoid lupus erythematosus, the damaging cells are believed to be a type of white blood cell called a T lymphocyte. The injury to the skin results in inflammation and the characteristic discoid lesions.
In Discoid lupus erythematosus, the characteristic skin lesion is circular and raised. The reddish rash is about 5-10 mm in diameter, with the center often somewhat scaly and lighter in color than the darker outer ring. The surface of these lesions is sometimes described as "warty." There is rarely any itching or pain associated with discoid lesions. They tend to appear on the face, ears, neck, scalp, chest, back, and arms. As Discoid lupus erythematosus lesions heal, they leave thickened, scarred areas of skin. When the scalp is severely affected, there may be associated hair loss (alopecia).
People with Discoid lupus erythematosus tend to be quite sensitive to the sun. They are more likely to get a sunburn, and the sun is likely to worsen their discoid lesions.
Diagnosis of Discoid lupus erythematosus
Diagnosis of Discoid lupus erythematosus usually requires a skin biopsy. A small sample of a discoid lesion is removed, specially prepared, and examined under a microscope. Usually, the lesion has certain microscopic characteristics that allow it to be identified as a Discoid lupus erythematosus lesion. Blood tests will not reveal the type of antibodies present in SLE, and physical examination usually does not reveal anything other than the skin lesions. If antibodies exist in the blood, or if other symptoms or physical signs are found, it is possible that the discoid lesions are a sign of SLE rather than Discoid lupus erythematosus.
Treatment of Discoid lupus erythematosus
Treatment of Discoid lupus erythematosus primarily involves the use of a variety of skin creams. Sunscreens are used for protection. Steroid creams can be applied to decrease inflammation. Occasionally, small amounts of a steroid preparation will be injected with a née Discoid lupus erythematosus into a specific lesion. Because of their long list of side effects, steroid preparations taken by mouth are avoided. Sometimes, short-term treatment with oral steroids will be used for particularly severe Discoid lupus erythematosus outbreaks. Medications used to treat the infectious disease malaria are often used to treat Discoid lupus erythematosus.
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