Discoid lupus erythematosus is a chronic skin disease that causes red, scaly lesions in various parts of the body. It may appear similar to other conditions, so the diagnosis is not straightforward. If you are concerned that you have discoid lupus erythematosus, go to a doctor immediately to get an official diagnosis and start treatment. prompt treatment is crucial to reduce the chances of serious side effects, such as permanent and disfiguring skin damage and alopecia. The most common treatments include reducing sun exposure, applying topical corticosteroids and taking antimalarial drugs.
Steps
Part 1 of 3: Recognizing the Signs of Discoid Lupus Erythematosus
Step 1. Recognize the symptoms
People with this autoimmune disease typically complain of mild itching and occasional pain, but many other patients do not experience these symptoms or other sensations associated with the lesions. The signs often show up in areas of the skin exposed to the sun, but 50% of the lesions are found on the scalp. Physical symptoms are:
- Red, scaly, raised lesions on the top and bottom of the neck; they often have the shape of a coin and the skin seems thickened;
- Obstruction of the hair follicles leading to hair loss;
- Skin discolouration: the lesions are lighter in the center (loss of pigment) and darker at the edges (hyperpigmentation);
- Atrophic lesions, scars and the presence of telangiectasia, a dilation of the subcutaneous capillaries that makes the lesions similar to branches.
- It is also common to experience photosensitivity.
Step 2. Remember that there are other conditions that can have symptoms and signs similar to those of discoid lupus erythematosus
Symptoms include (but are not the only ones) skin lesions caused by:
- Syphilis;
- Actinic keratosis;
- Complications of sarcoidosis;
- Lichen planus;
- Plaque psoriasis.
Step 3. Go to a doctor immediately to get a diagnosis
If you suspect you have this disease, make an appointment with a dermatologist as soon as possible. In most cases, a diagnosis is made by observing the clinical signs, that is, what the dermatologist can see during the visit. Sometimes a histopathology test is needed to rule out other skin conditions.
- Discoid lupus can also occur as part of systemic lupus erythematosus (SLE). In fact, it affects 25 percent of people with SLE, and about 10-15 percent of discoid lupus patients develop SLE; the more widespread the former, the more likely the symptoms of both will coexist. Your doctor may order you to screen for SLE during the exam, sending blood and urine samples to be analyzed in a laboratory.
- SLE patients have low or negative anti-nuclear antibody values, and rarely have anti-SS-A antibodies.
Part 2 of 3: Consider the Risk Factors
Step 1. Determine if Lupus Erythematosus was triggered by drugs
In this case, the disease is triggered by drugs and leads some individuals to show typical symptoms, even though they do not have systemic lupus erythematosus. This is a transient disorder that usually resolves within several days or weeks after stopping therapy. Talk to your doctor if you suspect the medications you are taking are causing your symptoms. Although there are many medicines that can trigger these adverse effects, the most common are:
- Hydralazine;
- Procainamide;
- Isoniazid.
Step 2. Review your family's medical history
Many people with lupus have family members with the same disease or another autoimmune disorder, such as rheumatoid arthritis. If possible, try to read up on your family history before going to the dermatologist; information about the health of your relatives is invaluable in coming to a diagnosis.
Step 3. Remember that lupus is more common in certain demographics
In addition to the other risk factors you need to consider, gender and race also play an important role. Women seem more affected than men, and lupus is more common among African Americans and individuals between the ages of 20 and 40. Your doctor may consider all of these details before coming to a conclusion about your illness.
Part 3 of 3: Treating Discoid Lupus Erythematosus
Step 1. Protect yourself from the sun
Symptoms of this disease worsen with exposure to the sun or UV rays in general; for this reason, do not spend too much time outdoors when it is sunny. Try to go outside only when the natural light intensity is not high, such as in the early morning or late afternoon.
- Apply full screen protector and wear opaque clothing to avoid contact with ultraviolet light.
- Don't use tanning beds and don't sit by the window in the office.
- Be very careful when you are in areas with bodies of water, snow or white sand, as these elements reflect ultraviolet rays.
Step 2. Ask your doctor to prescribe corticosteroid creams
Topical products are widely used to treat discoid lupus erythematosus. Your dermatologist will likely recommend that you start with a high-strength cream spread twice a day, then move on to a maintenance dosage. This change in dosage is designed to avoid the negative effects of drugs, such as the formation of red and atrophic scars.
Steroid injections can be helpful in treating chronic lesions, skin thickening, or other symptoms that do not respond to the application of creams. Be sure to inquire about this possibility from your doctor
Step 3. Ask your dermatologist about oral medications
Antimalarial drugs are often prescribed to complement discoid lupus erythematosus therapy. They can be used alone or in combination and often contain chloroquine, hydroxychlorichine and mepacrine.
- Sometimes other drugs are also considered when antimalarial drugs, topical steroids and injectable ones have not brought the desired results. In this case, methotrexate, cyclosporine A, tacrolimus and azatrioprine may be prescribed.
- The dosage of the drug is established based on the patient's lean mass to minimize toxic effects.
