Lupus is an autoimmune disorder, where the immune system produces antibodies that attack the healthy cells and tissues of the body. The result is an inflammation or swelling, and pain of the affected regions or organs. Lupus can affect any part of the body, including the skin, blood cells, joints, and the internal organs like the kidneys, lungs, and the heart. The disease can produce various symptoms including a skin rash.
The characteristic lupus rash can be observed in about 90% patients. This skin rash is found to be more prevalent among Caucasian patients, as compared to African-Americans. There are basically four types of lupus - systemic Lupus Erythematosus (SLE), discoid lupus, drug-induced lupus, and neonatal lupus.
The lupus rash is more commonly associated with systemic and discoid lupus. Systemic lupus can affect any part of the body, including the skin, while discoid or cutaneous lupus is usually confined to the skin only. Both the conditions can cause the appearance of a rash on the chest, neck, leg, or face, and other parts of the body.
Causes of Lupus Rash
The exact causes of lupus are not known with certainty. However, both genetic and environmental factors are believed to play a significant role in the development of this disorder. Lupus and the rash caused by it are found to be more prevalent among women, as compared to men. Generally, it is believed that certain individuals are genetically predisposed to develop this autoimmune disorder, and their immune system gets easily stimulated by certain environmental factors like sunlight or ultraviolet radiation, stress, and some drugs.
The rash has been observed to develop on those areas that remain exposed to sunlight. Therefore, it commonly appears on the neck, face, scalp, and the hands. On the other hand, women are more likely to develop a rash, and the symptoms of lupus in women are likely to worsen before menstruation. This led many to think that the female hormone estrogen could have a role in triggering the various symptoms of lupus disease, including the skin rash.
Characteristics and Types of Lupus Rash
The lupus rash can be of various types. The rash that appears in SLE usually resembles a butterfly in shape, and it usually appears on the face and across the nose bridge. This type of rash is known as 'malar rash', which is a characteristic feature of SLE. The 'malar rash' can be flat or raised, and bright red or pink in color. On the other hand, the rash caused by discoid lupus, is usually oval or disk-shaped and slightly raised. It can itch a lot, and occur in patches across the body. This rash usually heals with scarring, and it can change the pigmentation of the affected area. So, the affected area may look lighter or darker than the surrounding skin.
The skin rash caused by subacute cutaneous lupus usually affects the areas exposed to sunlight. The rash can be observed as a scaly patch that gradually enlarges and forms a circular area on the skin. Subacute cutaneous lesions can occur in both systemic and discoid lupus, and they usually do not cause scarring. But they can cause hypopigmentation, i.e., the skin of the affected area can look lighter than the surrounding area. Sometimes, lupus can also cause the appearance of fluid-filled blisters on the skin, which are accompanied by a burning sensation.
Lupus Rash Treatment
The treatment depends on the type of rash, and the severity of the condition. This condition is usually managed with topical ointments and creams that contain steroids. Hydrocortisone creams are more commonly employed for this purpose. Occasionally, oral medications can also be required to control recurrent outbreaks. If the condition causes the appearance of painful skin lesions, then steroid injections can be required.
To sum up, there can be different types of lupus, and they can produce different symptoms. In general, lupus and the skin rash caused by it can be controlled by avoiding excessive exposure to intense sunlight. So, be sure to use a good sunscreen lotion, and cover those parts of the body that are more likely to be affected by the rash before going out in the sun. Also important is to supervise the condition, find out the triggering factors, and design an effective treatment plan with your physician.