Discoid Lupus Erythematosus (DLE) can be disconcerting but with proper diagnosis and treatment it is manageable and should not cause any serious complications. Unfortunately, because so little is known about the causes of this particular skin ailment, it can be difficult to predict or prevent.
DLE is a skin condition linked to photosensitivity, or extreme sensitivity to sunlight. It is characterized by the development of scaly, red patches on areas of the skin that receive the most exposure to sunlight, including the cheeks, nose, ears, upper back, neck and backs of the hands. It can also occur on the scalp and the lips and inside the mouth.
In some cases, the dermatological version of DLE can develop into a more wide-spread, systemic version which can affect the internal organs. For this reason, it is very important to consult your doctor and have periodic checkups to stay on top of your condition.
Causes & Diagnosis
The cause of DLE is unknown, yet it tends to run in families so there may be a genetic component to it.
It affects 3 times as many females as males.
DLE is also known to be more prevalent among individuals with porphyria cutanea tarda, lichen planus and psoriasis.
Exposure to sunlight might make the lesions appear more prominently.
If a dermatologist suspects that you have this chronic condition, a biopsy will need to be performed to confirm the diagnosis because various other skin conditions can look like discoid lupus erythematosus.
If the biopsy shows discoid lupus erythematosus, then further tests may be necessary.
The lesions can cause permanent scarring as well as some hair loss. It tends to come and go, with flareups followed by periods of remission.
What are the treatment options for DLE?
Cortisone ointment applied directly to the skin in the involved areas will usually improve the lesions and slow down their progression. Cortisone injections into the lesions will also treat discoid lupus and are more effective than the ointment form of cortisone.
If the lesions are becoming unsightly and you really feel something more needs to be done, a drug called Plaquenil (hydroxychloroquine) will often improve the condition. Patients on Plaquenil do need eye exams once annually to prevent damage to the retina of the eye and periodic blood work to avoid potential complications.
Recent studies have also shown that the use of fluocinonide cream may actually be more effective for treating DLE than hydrocortisone. In the most severe cases, laser treatment may be useful for removing lesions.
Patients whose condition is sensitive to sunlight need to wear a sunscreen of SPF 15 or higher daily, and a hat while outdoors.
Follow-up with the doctor is important and necessary every six months to once a year to make sure the disease is not spreading to the internal organs and to minimize scarring.