Discoid Lupus Erythematosus (DLE): Causes, Symptoms, Treatment- Corticosteroids, Surgery

Lupus erythematosus is a term used for a group of disorders. Discoid lupus erythematosus is one of the disorders that falls in this group. It is characterized by an uncommon rash that usually gets worse when exposed to sunlight. Discoid lupus erythematosus, unlike the other varieties of its group, affects only the skin in general and does not lead to any other systemic health issues.

The exact reason of discoid lupus erythematosus is still not known, but the suspected cause implicates towards autoimmune disorder, which is usually responsible for forcing the immune system of the body to attack its own healthy tissues.

Generally, the immune system of the body acts as a shield in order to protect the cells from attacks of the foreign bodies like viruses and bacteria. In case of discoid lupus erythematosus, the immune system starts producing autoimmune antibodies that attack the healthy tissues of the body, mainly the skin. Individuals suffering with discoid lupus erythematosus also develop autoimmune antibodies in their blood.

Exposure to sunlight leads to worsening of the rash in discoid lupus erythematosus. It is neither a result of infection nor is a food allergy. Discoid lupus erythematosus is seen both in men and women though young women are more prone to it. It is very rarely seen in children.

Discoid lupus erythematosus is quite common in African Americans when compared to Asians and whites. The ratio of discoid lupus erythematosus between males and females is recorded as 1:2. Although it may affect at any age but it most often occurs in individuals in the age group of 20 to 40 years. The mean age in which people get affected with the condition is 38 years. Cutaneous lupus erythematosus affects women 2 to 3 times more when compared to men. Approximately 5 percent of discoid lupus erythematosus cases are recorded to in systemic lupus erythematosus that may affect any of the body organs.

Although the exact cause of discoid lupus erythematosus is unknown, the condition is suspected to be an autoimmune disorder. It generally results in inflammation and rashes on the skin. Family history could also be responsible for it. Discoid lupus erythematosus is also triggered by sunlight exposure and cigarette smoke.

• Development of rash on the scalp may form scarring, alopecia and bald patches.
• Scars and skin discoloration.
• Red, scaly or crusty lesions and patches develop on the skin.
• Hair loss.
• Raynaud’s phenomenon.
• Sun sensitivity.
• Joint pain.
• Itching and swelling on the skin.
• Pale or blue lips.
• Fast heart rate.
• Rapid breathing.
• Chest pain.
• Irregular heartbeat.
• Inability to urinate.

• Corticosteroids are the first step toward treating discoid lupus erythematosus as corticosteroids help in suppressing the immune system.
• Topical application of steroid creams.
• Affected area should be covered for increased absorption.
• Cortisone injections are used when creams do not work for lesions.
• Anti-malarial medicines.
• Psoriasis medication.
• Oral steroids.
• Disease Modifying Anti-Rheumatic Drugs (DMARDs).

Discoid lupus erythematosus can be controlled by avoiding and reducing the potential triggers. Precautions that help in easing the discomfort may include:

• Application of sun block or sunscreen.
• Limiting exposure to cigarette smoke and quitting smoking.
• Wearing headgear and protective clothing when outdoors.
• Regular checkups.

• Burnt out scarred lesions can be removed.
• Laser therapy can be considered for some prominent lesions.

• Biopsy of the lesion.
• Serology, specifically antinuclear antibody (ANA).
• ESR.
• Rheumatoid factor.
• Urinalysis.

Periodic blood tests are recommended to monitor for relapse of the condition.