What causes discoid lupus?

Skin is the largest organ for humans. It helps to protect humans from injury and to prevent loss of moisture. It also works as a thermoregulator to help regulate the body temperature and maintain the water and electrolyte balance. We can see how skin plays an important role in human life. There are several skin issues that could affect a person’s life. People may take supplements such as multivitamins to help their skin become healthy. Getting regular health screening may also be beneficial in detecting diseases that could be affecting the skin health.

One of the most common skin issues that may affect those with lupus is discoid lupus. To understand what discoid lupus is, you may want to understand a bit more what lupus itself is. Lupus is a chronic autoimmune disease, causing inflammation to any part of the body. An autoimmune disease means a disease caused by the immune system accidentally attacking its own human body. A lupus may cause a person to have joint pain, skin rashes and other organ damages. Most cases of lupus affect women.

Discoid lupus is a chronic scarring condition affecting the skin. A person with discoid lupus may have systemic lupus affecting the internal organ but it does not necessarily mean all persons with discoid lupus will have systemic lupus. It is said that more than 28% of patients with discoid lupus are susceptible to develop systemic lupus erythematosus (SLE). Discoid lupus may affect both male and females across all ages but is more likely common in women in their reproductive ages of 20-40 years old. It is also more common in skin of colour compared to white people and those who smoke. Lesions often get worse when it is exposed to ultraviolet light such as the sunlight and smoking.

What could be the causes of discoid lupus? First and foremost, as the name implies, is the presence of lupus itself. Lupus causes the immune system to have problems, making it attack its own healthy cells which are the skin. However, discoid lupus could also be caused by other factors such as genetic changes and environmental factors such as those who smoke and previous ultraviolet radiation.

Discoid lupus is characterised by the rash or acne-like with scaly dry surface that become into larger coin-shaped plaques. It is often seen around the face such as nose, cheek, lip, eyelids and neck area but may also be distributed across the front chest, upper back and back of the hand. The rash generally does not exhibit any symptoms but at times it can be itchy and sore. As discoid lupus expands, it may cause some part of the skin to be hyperpigmented (excess skin pigmentation), leaving a spot of scarring with hypopigmentation (lack of skin pigmentation) and prominent fine pink or red line of visible blood vessels colour known as telangiectasia. In regions with hair such as the scalp, scale or follicular plugging at the hair follicle can be seen and scarring alopecia (hair loss) may be found.

If a person found themselves with skin lesions such as mentioned previously, they should immediately seek medical advice. Medical examination will not only involve investigation to the skin, but also a complete examination of the body as medical professionals will investigate for possibilities of other signs of lupus. A skin biopsy is usually needed to confirm diagnosis alongside blood test and urine analysis. Those diagnosed with discoid lupus will need treatment of corticosteroids and immunomodulator to help treat the skin condition. Treatment plan and course may vary from one to another person depending on the severity of the discoid lupus and possibility of SLE itself. It is important to have discussions with healthcare providers about both diagnosis and treatment available.

Treatment for discoid lupus is divided into general measures and specific ones. For general treatment, patients need to be careful of sun exposure by wearing clothes that cover most skin and use high SPF broad-spectrum sunscreens. Patients may also use vitamin D supplements if they are advised to strictly avoid the sun. Of course, patients have to avoid smoking and being around those who smoke. For specific measures, medicines are usually prescribed by doctors. This includes topical and/or oral corticosteroids, topical tacrolimus or pimecrolimus and at times retinoids, immunoglobulins and biologic agents. Medicine may be used in combinations depending on the patient’s status. It is important to follow all advice from doctors when taking medication which includes taking it with the right dosage and frequency.

Discoid lupus may seem harmless as compared to SLE but the complication from it still can greatly affect a person’s quality of life. Scars from the discoid lupus can greatly cause facial disfigurement and permanent alopecia. Discoid lupus may also affect a person’s psychological state causing immense emotional distress. Getting treatment for discoid lupus may not only help them physically, but also emotionally so that they can have a fulfilling life.

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