Skin Disease
Introduction
Skin disease -- also called cutaneous disease -- is very common in lupus erythematosus (LE). Only joint pain (arthritis) is more common. People with lupus can develop many different types of skin lesions. The term "skin lesion" used here refers to a distinct area of abnormal skin.
Lupus skin disease can be divided into two broad categories:
- Skin lesions that are seen only in people with LE. These three types of lesions are:
- chronic cutaneous LE (CCLE), also called discoid LE (DLE)
- subacute cutaneous LE (SCLE)
- acute cutaneous LE (ACLE).
- Skin lesions that can occur in people with LE but can also occur in other diseases. There are a number of forms of skin disease in this category, such as:
- vasculitis
- calcinosis (calcium deposits in the skin)
- hair loss (alopecia)
- rheumatoid nodules
- Raynaud's phenomenon
- livedo reticularis.
Systemic Lupus and Discoid Lupus
A frequently asked question by people with lupus is: "What is the relationship between systemic LE (SLE) and lesions seen in discoid LE (DLE)?"
Lupus can be viewed as a disease continuum or spectrum:
- At the mild end of the spectrum are the minimally affected LE patients. They will have only localized DLE skin lesions.
- At the other end of the spectrum are patients who have active SLE with internal organ involvement. They will have ACLE skin lesions or no skin lesions at all.
- SCLE patients tend to fall toward the middle of the spectrum since they often have some evidence of mild SLE.
People with DLE lesions and no clinical evidence of SLE usually do not produce autoantibodies in their blood (i.e. antinuclear and anti-DNA autoantibody tests are negative). On the other hand, SLE is characterized by the presence of one or more types of such autoantibodies.
- Of the patients who initially have only DLE lesions, approximately 10 percent will go on to develop SLE.
- Of the patients with SLE, approximately 20-30 percent will develop DLE lesions at some time during the course of their disease.
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