Understanding Lupus Skin Symptoms Like Rashes and Lesions

Understanding Lupus Skin Symptoms and Rashes

Lupus is an autoimmune disease that can affect the skin, causing a variety of rashes and lesions. While there are some common lupus rashes, the presentation can vary significantly between patients. Being able to identify different types of lupus skin conditions is important for getting an accurate diagnosis and proper treatment.

Common Types of Lupus Rashes

Some of the most common lupus rashes include:

• Butterfly rash - This rash gets its name from the butterfly-like shape it forms over the nose and cheeks. The rash consists of flat, red patches and can cause the facial skin to scale and peel.
• Discoid rash - This is a raised, scaly, red rash that often shows up on the face, ears, and scalp. It can cause permanent scarring and hair loss.
• Subacute cutaneous lupus - This photosensitive rash appears after sun exposure. The skin lesions do not scar but can be widespread.
• Tumid lupus - This form causes swollen, red bumps and plaques on the arms, shoulders, and trunk area.

Identifying Specific Lupus Skin Conditions

While those are some of the most common lupus rashes, there are many other possible skin conditions that can develop. Being able to distinguish and identify the different types of lesions and symptoms is crucial for getting proper treatment.

Butterfly Rash (Malar Rash)

The classic butterfly-shaped rash is one of the most identifiable signs of lupus. It appears as a raised red rash across the cheeks and over the bridge of the nose, resembling a butterfly's wings. This facial rash may be flat or raised and can cause flaky, scaly patches on the skin that peel away. It is also photosensitive, meaning sun exposure can trigger or worsen the rash.

Discoid Lupus Rash

Discoid lupus causes a red, raised rash on the skin that can scar. It often appears on the face as a disk-shaped lesion with a scaly, flaky surface. Because discoid lupus can cause scarring alopecia, rashes on the scalp may lead to permanent hair loss. This type of lupus rash may also appear on the ears, arms, and lips.

Subacute Cutaneous Lupus

Subacute cutaneous lupus causes skin lesions on areas of the body that are exposed to sun. The rash consists of oval or circular red patches and can have a scaly, flaky appearance. While this photosensitive rash is often widespread, it does not scar. Skin lesions typically resolve without treatment after sun exposure is avoided.

Tumid Lupus Rash

Tumid lupus causes reddish bumps and raised plaques on the skin. This form of lupus rash is non-scarring and photosensitive. Lesions are typically seen on the arms, shoulders, neck, and trunk. The bumps may be mildly painful or irritated.

Other Symptoms of Cutaneous Lupus

In addition to the array of rashes caused by lupus, the condition can have other effects on the skin and hair. These include:

• Hair loss or thinning hair - This can result from discoid lesions on the scalp.
• Fingernail lesions - These may appear as red or white bands, pits, grooves, or other abnormalities.
• Oral ulcers - Sores may develop inside the mouth or nose.
• Skin lesions - Open sores, bruises, or hives may develop on the skin.
• Raynaud's phenomenon - Fingers and toes turn white or blue in cold temperatures.
• Sensitive or painful skin - Affected areas may be uncomfortable when touched.

What Causes Lupus Skin Conditions?

The rashes and lesions of lupus are thought to be caused by inflammation of the small blood vessels that supply the skin. Inflammation leads the blood vessels to dilate and leak, allowing fluid and cells to accumulate in surrounding tissues. This results in the red, swollen lesions that are characteristic of lupus rashes.

Certain rashes like subacute cutaneous lupus are triggered by sun exposure. Ultraviolet light is thought to induce an inflammatory reaction in patients genetically predisposed to lupus. The rashes appear predominantly in sun-exposed areas.

Getting Proper Diagnosis of Lupus Skin Symptoms

Because lupus rashes can vary widely in appearance, getting a proper diagnosis can be difficult. Primary care physicians may not have extensive experience recognizing or treating lupus rashes.

To get the right diagnosis, it is best to see a dermatologist or rheumatologist. They specialize in identifying autoimmune conditions like lupus that affect the skin and joints.

Doctors will evaluate all of your symptoms, review your medical history, and conduct a physical exam. A skin biopsy of one of the lesions may be taken to look at the skin tissue under a microscope. Blood tests can also help confirm systemic lupus erythematosus.

Available Treatment Options for Lupus Rashes

While there is no cure for lupus itself, the skin symptoms caused by the condition can be effectively treated. Some options may include:

• Steroid creams and ointments - These can help reduce redness, swelling, and itching of skin lesions.
• Antimalarial drugs - Plaquenil (hydroxychloroquine) can help treat discoid lupus and subacute cutaneous lupus.
• Immunosuppressive medications - Drugs like methotrexate and CellCept (mycophenolate) suppress the overactive immune system.
• Biologic therapies - Newer drugs like Benlysta (belimumab) reduce immune activity by targeting specific proteins.
• Light therapy - Controlled doses of UV light can help treat severe rashes and lesions.

In addition to medications, patients should limit sun exposure by wearing protective clothing, hats, and sunscreen. Good sun protection habits can help prevent photosensitive rashes from occurring.

Coping With the Emotional Impact of Lupus Rashes

For many patients, the visible facial rashes and lesions caused by lupus can take a significant emotional toll. Red, scaly patches on the face can cause major self-esteem and body image issues.

Some helpful coping tips include:

• Getting psychological counseling or joining a support group to discuss concerns with others who understand.
• Exploring cosmetic techniques like camouflage makeup, fillers, or micropigmentation to mask scarring or lesions.
• Practicing self-care techniques like meditation, yoga, journaling, or affirmations to build confidence.
• Making lifestyle adjustments to reduce stress and flare-ups of skin symptoms.

While living with chronic skin conditions like lupus rashes can be challenging, being proactive with treatment and self-care makes it possible to find better balance and self-acceptance.

The Bottom Line

Identification of the specific type of lupus skin rash is key to getting the right diagnosis and treatment. The constellation of rashes caused by lupus may appear vastly different between patients, but they all stem from the shared autoimmune process that underlies lupus.

With proper diagnosis by a specialist, the right medications, protection from UV light, and support for emotional health, the skin conditions resulting from lupus can be effectively managed.

Disclaimer: This article is for informational purposes only and does not constitute medical advice. Always consult with a healthcare professional before starting any new treatment regimen.