Discoid lupus primarily affects the skin and is related to systemic lupus erythematosus. It is believed to have a genetic component and affects more women than men. Exposure to sunlight and smoking can trigger symptoms. Treatment includes topical corticosteroids and other medications, but hydroxychloroquine can cause irreversible damage to the retina. Sun protection is important in preventing symptoms.
Discoid lupus erythematosus is an autoimmune disease related to systemic lupus erythematosus (SLE), but although SLE usually affects multiple organ systems, discoid lupus primarily affects the skin. The causes of discoid lupus aren’t fully understood, but because the disease tends to run in families, experts believe there is a genetic component. The disease affects two to three times as many women as men, and up to 10 percent of discoid lupus sufferers eventually develop SLE. Symptoms of discoid lupus are characterized by a red, scaly rash that can develop into a disc-shaped sore that slowly expands outward.
Discoid lupus symptoms most often develop on areas of skin exposed to sunlight, but they can appear anywhere. When the disease is limited to the head and neck, it is called localized discoid lupus, but when the symptoms of discoid lupus appear on other areas of the body, it is called diffuse discoid lupus. Discoid lupus sores can cause scarring, and lesions that occur on hair-covered areas of skin can cause permanent hair loss. Exposure to sunlight can trigger discoid lupus symptoms in photosensitive people, even on areas of skin that haven’t been exposed to sunlight. Cigarette smoking is also thought to trigger symptoms.
Doctors diagnose discoid lupus with a physical exam and a skin biopsy. If the biopsy confirms discoid lupus, patients are often tested for SLE to make sure no other organ systems are involved. If patients test negative for SLE, they are typically re-tested every 12 to 12 months. Individuals with discoid lupus who develop SLE usually experience a relatively mild manifestation of the systemic disease. People who develop discoid lupus earlier, those who have diffuse rather than localized discoid lupus, and those who develop multiple sores are more likely to develop SLE.
The symptoms of discoid lupus are usually treated with topical corticosteroids. If this proves ineffective, cortisone shots can be administered directly into the sores. Calcineurin inhibitors, pimecrolimus cream, tacrolimus ointment, and antimalarials such as hydroxychloroquine can also be used to treat discoid lupus, but doctors generally try to avoid prescribing hydroxychloroquine because it can cause irreversible damage to the retina . Individuals taking hydroxychloroquine should have routine eye and blood tests to monitor the drug’s effects. Individuals can help prevent discoid lupus symptoms by using a sunscreen that protects against ultraviolet A and ultraviolet B light and by wearing protective clothing and hats.
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