Discoid Lupus Erythematosus

A disorder in which itchy, red, scaly patches develop, usually on the face and scalp and behind the ears

  • Most common between the ages of 25 and 45
  • Much more common in females
  • Sometimes runs in families
  • Strong sunlight triggers or aggravates the condition

Discoid lupus erythematosus (DLE) is an autoimmune disorder, in which the body attacks its own tissues. It causes a red, itchy, scaly rash to appear, particularly on the face and scalp, behind the ears, and on any parts of the body that are exposed to sunlight. The disorder most commonly occurs in women between the ages of 25 and 45. The cause is unknown, but a genetic factor may be involved because DLE tends to run in families. Exposure to sunlight tends to trigger the onset of the rash or to make an existing rash worse. Over a period of several years, DLE may subside and recur repeatedly with different degrees of severity.

In some cases, the rash disappears, but it can leave behind a scarred area in which the skin is thin and discoloured.

If DLE occurs on the scalp, the damage to the skin can result in permanent loss of hair and patchy baldness of the scalp (see Alopecia).

Rash of discoid lupus erythematosus

This red facial rash is characteristic of discoid lupus erythematosus. The distinct, discoloured patches are due to scarring from previous episodes of the disorder.

What might the doctor do?

Your doctor will probably arrange for a small sample of skin to be removed from an affected area (see Skin biopsy) to confirm the diagnosis. If you have DLE, your doctor may prescribe a topical corticosteroid, which you apply to the affected areas of skin two or three times a day.

If the skin has not healed after the corticosteroid treatment, your doctor may prescribe a course of chloroquine, an antimalarial drug that often relieves the symptoms of DLE. The doctor will advise you to have regular eye examinations while you are on this drug because chloroquine may eventually cause damage to the eyes.

What can I do?

You can help control the rash by staying out of the sun or by using a sunscreen that provides full ultraviolet protection to your skin (see Safety in the sun). Concealing creams may improve the appearance of discoloured skin.

What is the prognosis?

Most cases of DLE can be successfully treated with corticosteroids, although scarring can occur. About 1 in 20 people with DLE goes on to develop a related, but frequently more serious, autoimmune disorder called systemic lupus erythematosus. This condition affects many parts of the body, including the lungs, kidneys, and joints.

From the 2010 revision of the Complete Home Medical Guide © Dorling Kindersley Limited.

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