Discoid lupus erythematosus (DLE) is a chronic skin disorder with red, raised plaques (scales) having sharp edges. The lesions usually occur on sun-exposed areas, especially the face, scalp, and neck.
DLE can be more frequent and more severe in African Americans. It affects women more often than men, usually adults between ages 20 and 50. Remissions occur between episodes.
Other family members may have DLE, but it is not contagious.
Some people with DLE develop systemic lupus erythematosus (SLE), a more serious disease involving many body organs.
The cause is unknown, but DLE is likely an autoimmune condition (i.e., one in which the body’s immune system attacks itself, causing injury or disease). Exposure to sunlight may increase the risk of getting DLE.
Lesions are red, raised bumps (papules; smaller than 1 centimeter) and scales (plaques; larger than 1 centimeter) with clear borders. Lesions may also have scaling and thinning (atrophy) of the skin. Scarring is common.
In African Americans, lesions may be darker than normal skin. Lesions tend to be round or oval with irregular borders. They involve the face, scalp, neck, nose, forearms, hands, fingers, and toes. Sometimes, the trunk and mucous membranes are involved. Scalp lesions are often related to hair loss.
Later lesions tend to be flat and faint pink or white. They tend to show atrophy and depression in the center, with slightly raised borders.
The health care provider makes a diagnosis from the look of the skin. The health care provider may do blood tests and a skin biopsy (removing a small piece of skin for study).
Treatment depends on its location and how severe, its impact on quality of life, and response to therapy. DLE can be controlled but cannot be cured. Treatment lessens the severity of the condition and reduces scarring. Treatment includes avoiding triggers (sunlight and fluorescent lights), general measures, and medicines. Use maximum protection sunscreens and wear protective clothing.
Sunscreens with a sun protection factor (SPF) of 30, steroids, and drugs to inhibit the immune system can reduce inflammation (redness, swelling), scarring, and lessen the severity of DLE.
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Copyright © 2016 by Saunders, an imprint of Elsevier, Inc.
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