Lupus Erythematosus

What are the types of lupus erythematosus ?

• There are three types:

1. Systemic (or acute) lupus erythematosus: important involvement of the internal organs with or without skin manifestations.
2. Subacute lupus erythematosus: moderate internal involvement with cutaneous manifestations.
3. Discoid (or chronic) lupus erythematosus: skin involvement only.

How does lupus erythematosus appear on the skin?

• Generally speaking, people with lupus are very sensitive to sunlight (photosensibility).
• Systemic lupus erythematosus is caracterised by a “butterfly” eruption (rash) on the face:

1. The rash on the cheeks are the “wings”  of the butterfly.
2. The rash on the nose is the “body” of the butterfly.

Systemic Lupus Erythematosus:

• Patients with subacute lupus erythematosus can develop a skin rash:

1. Which can be scaly (as in psoriasis) or simply appear as redness on otherwise smooth skin.
2. Which is localized on sun-exposed areas, more likely so on the face and back of the forearms.

• In discoid (chronic) lupus erythematous (but also in the other types) patients can develop:

1. dark elevated lesions which feel rough when touched.
2. even rougher lesions at the orifices of the hair follicles.

Discoid Lupus Erythematosus

Does lupus erythematosus only affect the skin?

• In all types, mouth ulcers can appear.
• The kidneys, joints, wrapping membranes of the heart (pericardium) and lungs (pleura), brain, cells in the blood can all be involved in systemic lupus erythematosus, even if the skin isn’t.

I am sunburnt. Do I have lupus erythematosus?

• Being sunburnt with a redness on the face which looks like a butterfly rash does not necessarily mean that you have lupus erythematosus or that you may be at increased risk of having it one day.
• If in doubt, consult a dermatologist.

Contributors:

Dr Christophe HSU – dermatologist. Geneva, Switzerland