Different Types Of Lupus
There are different types of skin involvement in Lupus Erythematosus.
Lupus Erythematosus – Specific Skin Disease:
These are scarring, coin-shaped lesions commonly seen in areas of skin that are exposed to light, such as the scalp, and ears, and the central portion of the face and nose. More rarely, your lips, mouth, and tongue might be involved. These lesions can produce a scarring baldness, and because they often affect your face, you may consider getting cosmetic treatment. Only 1 in 10 to 1 in 20 of patients who are initially diagnosed with this type of skin involvement, will eventually develop the severe form of the disease that involves other organs in your body.
Subacute cutaneous lesions:
These are non-scarring, red and scaly lesions that are very photosensitive, that is they get worse when they are exposed to ultraviolet light. They tend to occur on the face in a butterfly shaped distribution or can be more widespread on the body. Even though these lesions do not result in scarring, their extent and color change can cause you major cosmetic concerns. About half of the patients who are diagnosed with this type of skin involvement will, in time, develop other organ involvement (also called systemic involvement or systemic disease), such as arthritis conditions with their blood. Kidney disease is unusual in patients with this type of skin disease.
This is a rare type of skin lupus erythematosus in which the subcutaneous fat is involved giving rise at first to tender nodules that can leave, in time, saucer like depressions in the skin surface. This type most commonly affects the upper arms and trunk. Patients with this type of skin involvement may have either systemic disease or disease limited to the skin.
Acute Lutaneous Lupus Lesions:
The malar rash or butterfly rash occurs in association with systemic lupus erythematosus. It is seen in up to 2/3 of patients with systemic disease and may be the presenting feature in up to 40%. It may vary in degree from a mild redness or “rosy cheeks”, to multiple swollen red areas or plaques.
Lupus Erythematosus – Non-Specific Skin Disease:
The following are skin changes that are noted in some patients with lupus erytheamtosus but also occur in many patients without lupus erythematosus. Thus having one of the conditions listed below does not mean that there is a predisposition to developing lupus erythematosus.
Up to 1/3 of patients with systemic lupus erythematosus get reversible form of hair loss associated with flares of their systemic disease. They may also note, that their hair is more brittle than previously and breaks easily giving rise to shortened hair (“lupus hair”). Another form of reversible hair loss that leaves distinct bald spots, alopecia areata, may also be more common in patients with lupus erythematosus.
Patients with systemic lupus erythematosus may develop inflammation of their blood vessels, this can result in varied manifestations running a spectrum from multiple scattered red bumps, that may crust and ulcerate to painful nodules.
Varied skin manifestations:
This is the blanching of the skin of the fingers and toes when exposed to cold and may be followed by a blue or red discoloration.
This is a cold induced injury that results in tender nodules and plaques on the fingers and toes.
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