What is Cutaneous Lupus Erythematosus

Cutaneous lupus erythematosus is a term describing a range of dermatological conditions, that may or may not be associated with the development of systemic lupus. Cutaneous lupus is three times more common that systemic lupus.

Lupus is an autoimmune disease, affecting multiple organs and systems in the body. A person’s immune system attacks various cells in it’s own body, which can cause a variety of symptoms, including lupus-specific skin lesions and non-specific skin lesions.

Cutaneous lupus erythematosus (CLE) more prevalently affects women ages 20-50 and is typically triggered by sunlight.

Lupus is not contagious, even via sexual contact. In other words, it is not possible to catch lupus from someone or give lupus to someone else.

Diagnosing Cutaneous Lupus

While it is up to a doctor to make a full diagnosis, there are some symptoms of the disease that may be noticeable that can cause you to be concerned about the presence of the illness. The most notable symptom is the presence of rashes throughout the body.

Discoid lupus erythematosus

Discoid lupus erythematosus lesion on the face of the musician Seal.
Credit: Eva Rinaldi – Seal, CC BY-SA 2.0.

One type of rash that is particular indicative of a case of acute cutaneous lupus erythematosus is known as a butterfly rash in which an individuals cheeks and bridge of the nose are covered with a rash, resembling the shape of a butterfly with its wings spread. The rash may be a simple tint to the skin, or it may be a drastic one that is raised off of the surface of the skin.

Going along with this symptom is usually a case of photosensitivity in which an individual is particularly susceptible to skin problems caused by exposure to the ultraviolet light of the sun. Ulcers may also be present in the mouth or the nose of an individual that is afflicted with cutaneous lupus.

Since the types of skin rashes that occur when an individual has a case of cutaneous lupus can vary to a great degree, it can be difficult for a doctor to clearly diagnose. To that end, doctors often take a biopsy of a rash in order to properly identify the problem that is present.

Subacute cutaneous lupus erythematosus (SCLE) typically develops on areas of the body exposed to the sun, such as the upper torso, neck, lower arms, upper back, and shoulders, although the face is often unaffected. In these areas skin lesions will appear as areas of red scaly skin with distinct edges or as red, ring-shaped lesions.

A third type of the disease is Chronic cutaneous lupus erythematosus (CCLE), which itself is divided into three types- discoid lupus erythematosus (DLE), tumid lupus, and lupus panniculitis.

What makes Cutaneous Lupus Different from Systemic Lupus?

Systemic lupus is a type of disease in which the immune system attacks the organs of the body. In a case of cutaneous lupus, the immune system will only attack the skin, leaving the other organs of the body unaffected.

For that reason, systemic lupus is a much more dangerous form of the disease since it can result in serious organ damage as well as death. However, a case of cutaneous lupus may develop into the more deadly systemic lupus, although it is a problem that only occurs in roughly ten percent of all cases of cutaneous lupus.

Of all cases of lupus that are diagnosed, seventy percent relate to cutaneous or systemic lupus. Amongst that seventy percent, approximately fifty percent of the cases are systemic lupus and fifty percent are cutaneous lupus.

If you think that you may be experiencing a case of this condition, it is important for you to speak with a qualified dermatologist or physician that is properly experienced when it comes to dealing with skin conditions such as cutaneous lupus.

Treatment for cutaneous lupus depends on the form it takes. Oral antimalarial medications are considered first-line therapy for all CLE subtypes, and include Hydroxychloroquine, chloroquine, and quinacrine.

Common medications are topical applications, such as steroid creams or gel. In certain cases liquid steroids are injected into the lesions.

Tebbe B, Orfanos CE
Epidemiology and socioeconomic impact of skin disease in lupus erythematosus
Lupus 1997;6(2):96-104

Fabbri P, Cardinali C, Giomi B, Caproni M.
Cutaneous lupus erythematosus: diagnosis and management
Am J Clin Dermatol. 2003;4(7):449-65

Top image: Wellcome Photo Library, Wellcome Images