Does lupus affect the skin?

A person with lupus will most likely experience some skin problems. Skin conditions comprise four of the 11 criteria that the American College of Rheumatology uses to classify lupus. There are several major types of skin disease specific to lupus as well as various other non-specific skin problems associated with the disease.

A person with lupus may have multiple types of lesions. Additionally, a person can have these skin conditions without actually having full-blown lupus; the presence of any one of these disease forms, though, may increase the risk of developing lupus later in life.

Usually, the doctor will need to take a skin biopsy to diagnose these skin conditions. Fortunately, there are a variety of treatment options, including steroid ointments, corticosteroids (e.g., prednisone), and antimalarials (e.g., Plaquenil).

Types of lupus-specific skin problems include:

•Chronic Cutaneous Lupus Erythematosus (CCLE) / Discoid Lupus Erythematosus (DLE) - These skin lesions are thick and scaly, plug the hair follicles, appear usually on surfaces of the skin exposed to sun (but can occur in non-exposed areas), tend to scar, and usually do not itch.
•Subacute Cutaneous Lupus Erythematosus (SCLE) - Lesions characteristic of this condition usually do not scar, do not appear thick and scaly, and usually do not itch.
•Acute Cutaneous Lupus Erythematosus (ACLE) - These lesions usually appear in areas exposed to the sun.

Other common lupus skin problems include:

•Malar rash - A characteristic rash in the shape of a butterfly on the face.
•Photosensitivity - Sensitivity to sunlight, which can produce a rash that develops after sun exposure
•Livedo reticularis - A violet lacy pattern that develops under the skin.
•Alopecia - Hair loss, which is characterized by dry, brittle hair that breaks.
•Oral and nasal ulcers - Lesions that affect the mouth, nose, and even the eyes.
•Raynaud's phenomenon - Susceptibility to cold temperatures, which may cause discoloration of fingers and toes in cold temperatures.
•Hives - Lesions that usually itch and last more than 24 hours, unlike non-lupus hives which are more commonly caused by allergic reactions.
•Purpura - Small red or purple discolorations caused by leaking of blood vessels just underneath the skin.
•Cutaneous vasculitis - Hive-like lesions on the skin that may itch and do not turn white when depressed.