A lupus rash on the skin is a common symptom of lupus. In fact, 74 percent of lupus sufferers experience some sort of skin rash. A butterfly-shaped rash spread across the face, specifically the cheeks and nose, occurs in about 40 percent of people with lupus. Thirty percent experience sensitivity of the skin to sunlight and exposure makes the skin rash worse. Other lupus symptoms related to the skin include: hair loss in about 30 percent of individuals, fingers turning white or blue in the cold in about 17 percent, and mouth ulcers or nose sores that are usually not very painful in approximately 12 percent of lupus sufferers.
However, a lupus rash depends on the type of lupus that is present. There are three main types of lupus and the various rash symptoms for each type are described below. This type of information can be used to help diagnose the type of lupus that is active.
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In terms of how lupus affects the skin, discoid lupus (which is also referred to as cutaneous lupus) is the most prominent. Discoid lupus concentrates on the skin of affected individuals and does not in most cases affect other organs of the body. However, about 10 percent of the people with discoid lupus may develop systemic lupus, which is more serious and is discussed below.
This type of lupus butterfly rash normally appears on the head area, in particular the scalp, face, and neck. When present on the face, the rash is often in a butterfly pattern with the wings under the eyes and on the cheeks and the body of the butterfly on the nose. This lupus skin rash can also be present in patches on various other areas of the body. The patches are characterized by raised, thick, and scaly or crusty skin that are slightly red or light pink in color and may cause itching. The skin patches are often described as being coin-shaped or oval. Healing of the skin patches tends to result in scaring of the skin. For darker skinned individuals, the skin pigment may be affected and white skin patches or skin discoloration becomes evident after the skin heals. If this lupus rash occurred on the scalp, permanent hair loss will occur where the skin patches were present.
The discoid rash on the skin is rather unpredictable. It can last for a few days or a few months. It is also likely to reoccur in the future.
This type of lupus rash is characterized by small pimples in the initial stages. These small pimples transform into scaly and itchy skin areas. In some cases, the affected skin areas are large, itchy, flat lesions with clear centers. The skin is often very red and the lesions tend to be coin-shaped. This type of lupus skin condition is commonly triggered by exposure to sunlight. The lesions that form with subacute cutaneous lupus do not scar as is the case with discoid lupus. Often this type of lupus rash is similar to the skin problems that occur with psoriasis.
This is a more severe form of lupus and about ten percent of people with cutaneous lupus will go on to develop this form. Not only can a lupus rash occur on the skin, but also other internal organs of the body are affected. Some state that the malar rash or butterfly rash is most often associated with this form of the lupus disease.
Vasculitis or the inflammation of blood vessels may occur with systemic lupus. This is characterized by the presence of red welts over large areas of the body, red bumps on the legs that eventually form ulcers, or the appearance of red to purple lesions on the pads of fingers and toes or on the skin near the fingernails or toenails.
Certain drugs may cause the onset of lupus symptoms. Once the drugs are discontinued, the symptoms usually disappear.
Treatments for skin problems associated with lupus include topical steroidal creams and ointments, steroid injections under the skin, oral medications that need to be taken for several months, and avoidance of sunlight and use of sunscreens.
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