Lupus Skin Disease Presents In Different Forms

Individuals with lupus often develop skin rashes and lesions on areas of the body exposed to the sun. A butterfly rash that develops on the cheeks and across the bridge of the nose is a common skin condition associated with lupus. But there are a number of other skin problems that can occur. If you have lupus and develop unexplained skin rashes or sores, report it to your doctor who may refer you to see a dermatologist for diagnosis and treatment of lupus-related skin disease. Here's a look at a few of the possible problems you might encounter:

Subacute cutaneous lesions

Subacute cutaneous lesions look like patches of red, scaly skin or ring-shaped lesions. The lesions usually develop on the arms, shoulders, neck, chest, and back on areas of the skin frequently exposed to the sun. Although the lesions don't cause itching or scarring, they can become discolored. Along with skin disease, about half of individuals with subacute cutaneous lupus erythematosus develop joint pain, reports the American Osteopathic College of Dermatology.

Acute cutaneous lesions

Acute cutaneous lesions develop when systemic lupus is in the active stage and you are in a flare. A butterfly rash on the face resembles sunburn and is highly photosensitive (sensitive to light). The rash, which can appear on other areas of the body, doesn't usually lead to scarring, but it can cause changes in skin color.

Discoid lupus

Discoid lupus is characterized by red, scaly, disk-shaped lesions that can eventually cause scarring and skin discoloration. Scarring that occurs from sores that form on the scalp can lead to permanent hair loss. While lesions typically appear on the face and scalp, this form of lupus skin disease can affect other parts of the body. You also are at risk for developing cancer in lesions you've had for a long time; therefore, it's important to report any changes in the color, size, or shape of a lesion to your doctor.

Like other forms of cutaneous lupus, the lesions are photosensitive. Therefore, you need to take preventive measures:

• Limit how much time you spend outdoors or under fluorescent lights. Use acrylic fluorescent light diffusers to absorb UV-B radiation, which causes light toxicity in individuals with systemic lupus erythematosus.

• Always apply sunscreen before going outdoors, even on cloudy or rainy days. Use a sunscreen with an SPF of at least 30, recommends the American Academy of  Dermatology.

• Stay out of the sunlight between the hours of 10 a.m. and 4 p.m. when the rays from sunlight are strongest. If you go outside, wear sunglasses, protective clothing, and a wide-brimmed hat.

In addition to lupus skin disease, you can have other skin problems including:

Raynaud's phenomenon

Inflammation of smaller blood vessels restricts blood flow to the skin, causing the tips of your fingers to turn blue, red, or white, especially in cold weather . Known as Raynaud's phenomenon, symptoms include numbness, tingling, or pain in your fingers and toes. The condition is more common in women than men.

Palmar erythema

Another skin condition that can worsen in cold weather, palmar erythema is caused by abnormal blood flow through the capillaries and small arteries. The condition appears as redness on the palms of the hands or as a bluish, lace-like mottling beneath the skin, usually near the thumb and little (pinky) finger.

Petechiae

Characterized by tiny red, purple, or brown spots on the skin, petechiae normally appear on the lower legs in clusters or as a rash. Caused by a low number of platelets in the blood, the condition is common in people with lupus.

Calcinosis

Kidney failure or a reaction to steroid injections used to treat lupus can cause calcinosis -- a buildup of calcium deposits under the skin. Although calcinosis is a rare complication of systemic lupus erythematosus, it can occur. The condition usually is painful.

If you think you have any of these issues, reach out to a local dermatologist, like Henry E. Wiley, III, M.D., for more details.