Lupus Rash: how to avoid it (Definition, Kinds, Symptoms, Causes)

What’s lupus rash? What are the features of which?

 

Lupus rash is a large-scale spread chronic disease that hits the autoimmune system, which is supposed to protect the body from strange objects that attack body like viruses and bacteria. Once an individual is infected by lupus, the autoimmune system stops attacking foreign items that attack the body; rather, it, in severe cases, causes damages to vital body organs such as: the brain, lungs, kidneys, blood and the skin. So, it  affects every organ of the body causing severe inflammation and infections.

According to American statistics, 1.5 million Americans get affected by this disease.

  • Nine in every 10 people with lupus are females.
  • It’s more common in Afro-Americans, Hispanic\Latin, Asian or Native Americans women.

 

One’s immune system protects the body from viruses, bacteria and strange objects. After infection of  this pivotal system gets, it begins attacking the body tissues and vital organs. Unfortunately, Lupus extends to affect other organs of the body, such as: kidney, nervous system, blood vessels, and skin.

Lupus rash
Lupus rash

What are the symptoms and signs that one feels in case of infection?

The symptoms generally associated with lupus rash are similar to those that linked with flue. Among these symptoms, the patient feels the following:

  • Extreme tiresome.
  • Bad headache.
  • Fever.
  • Swelling in joints.
  • Pain in joints.
  • Prolonged fatigue.
  • Swelling in ankles.
  • Chest pain upon deep breathing.
  • Sensitivity to sun.
  • Hair loss.
  • Abnormal blood clotting.
  • Pale or purple fingers from stress or cold.
  • Seizures.
  • Mouth ulcers.

 

Unfortunately, Lupus rash is hardly diagnosed due to the similarity of the symptoms associated with it and those linked with other diseases, like: arthritis, fibromyalgia and thyroid problems. Therefore, this disease is also named ‘the great imitator.’

 

Joint pains and general weakness:

According to statistics issued by the Lupus Foundation of America, more than 90% of people with lupus skin rash face joint pains and general weakness in body. Not to mention discomfort caused by inflammation linked with lupus.

Additional, People with lupus rash  suffer from pain and stiffness in their joints namely ‘arthritis’.

Lupus rash also causes weakness in pelvis, thighs, and shoulders muscles.

Moreover, lupus rash may erupt carpal tunnel syndrome that leads to pain and numbness in the hands and fingers.

 

Disc-shaped Rash:

People with chronic Cutaneous lupus are more prone to get infected with this kind of rash.

As for the symptoms associated with this rash: it causes a coin-shaped red scaly rash that appears on cheeks, nose and ears.

This kind of rash is neither itchy nor painful; yet, once it disappears, it leaves the skin discolored. And which is more, hair may permanently fall.

 

Ring-shaped rash:

As the name says, this kind of rash looks like scaly red patches or ring shapes.

The symptoms of this rash usually appear on parts excessively exposed to sun like the arms, shoulders, neck, chest and trunk.

It mostly affects people with subacute cutaneous lupus as SCL makes you more sensitive to sun, so you need to be careful when you sit in sunshine or under fluorescent lights.

 

What are the causes of lupus rash on skin:

In general words, the causes of lupus are still mysterious. However, researchers and experts believe that genetic, hormonal and environmental reasons may come together and cause lupus.

Fortunately, lupus rash is not contagious; in a sense, one doesn’t catch it from others nor it’s sexually transferred.

Therefore, lupus rash has no identified causes; it is the excessive exposure to ultraviolet rays or intake of drugs may increase the possibility to get infected. Trauma, infection, stress, surgery and hormones may also trigger lupus.

 

Who is most likely to get infected?

Females are more prone to get infected with lupus than males because females’ sex hormones affect the immune system more. Although lupus may happen at any age, symptoms are more likely to appear at age between 15-44 years old.

 

Is lupus curable?

Well, initial diagnosis and treatment may well help to get the symptoms under control rather than getting much worse.

Once you are diagnosed, keep your body’s major organs, like heart, kidney, nervous system and lungs, under monitore

Most importantly, two cases of lupus have different symptoms, and therefore different treatment.

 

Medicines used to treat lupus:

  1. NSAIDS.
  2. Antimalarial drugs e.g.
  3. Corticosteroids.
  4. Immune suppressive agents, like: azathioprine, methotrexate, cyclophosphamide, cyclosporine, and mycophenolate mofetil.

 

Early symptoms of lupus:

 

  1. Fatigue: according to statistics issued by John Hopkins Lupus Center, 90% of people with lupus face different levels of fatigue. Try to keep yourself energetic as much as possible. In case you experience exhausting fatigue, you’d better consult your doctor. Fortunately, some causes of fatigue can be successfully treated.

 

  1. Unexplained fever: an initial sign of being infected with lupus is to have a low-grade fever, however, the reasons of this fever is still a matter of anonymity. Since the fever is of low degree (98.5-101 Fahrenheit) at the beginning, you may not think about seeing a doctor. Therefore, a low-grade fever is a signal of infection and inflammation, so you are recommended to consult your doctor while things are still under control before it gets much worse.

 

  1. Hair loss: when an individual gets infected by lupus, it causes damages to skin and the scalp, and the result is hair fall. Some people with lupus lose hair by clump, while it normally happens gradually and slowly. Unfortunately, hair falling may not be limited to the head, in a sense, it may extend to include hair of beard, eyebrows, eyelashes, and other body hair. Lupus also makes the hair brittle, breakable and ragged. Early treatment of hair fall may end up with renewed and healthy hair. However, if lesions appear on the scalp, hair loss may be permanent.

 

  1. Skin rash or lesions: one of the most common signs of lupus is butterfly rash on face. It’s also called malar rash. It’s formed on the cheekbones and nose taking the shape of a butterfly. According to statistics, 50% of people with lupus suffer from butterfly rash. Its appearance comes suddenly or once an individual with lupus exposes to sun.

 

  1. Pulmonary issues: inflammation of the pulmonary system is a symptom that a lot of people with lupus suffer from. Unfortunately, swelling and inflammation isn’t limited to lungs and may extend to include the blood vessels of the lungs. And at worst, the diaphragm may be affected and the patient ends up with ‘pleuritic chest pain‘, which is the pain a patient feels while taking breathe.

 

  1. Kidney inflammation: medically speaking, people with lupus may suffer from ‘nephritis’, which is the inflammation that makes it harder for the kidneys filter toxins and waste from the blood. According to statistics, kidney inflammation starts at any time within the first five years of the inflammation.

 

  1. Painful and swollen joints: infection of lupus causes pains, swelling and stiffness in joints especially in the morning. At the beginning, it might be mild, and then things get more and more painful. If over-the-counter medications don’t help, you’d better consult your doctor. Like all symptoms of lupus, swellings come and go if treated early.

 

  1. Gastrointestinal problems: people with lupus experience occasional heartburn, acid indigestion, or other gastrointestinal problems. Using over-the-counter medications, mild symptoms can be successfully treated. In case you experience frequent bouts of acid indigestion, or heartburn, try then to cut the size of your meals. Avoid drinks with caffeine and laying after a meal. If all these don’t work. Consult your doctor.

 

  1. Thyroid problems: people with lupus are mostly prone to develop autoimmune disease. Normally, the thyroid helps to control your body’s metabolism. malfunction of thyroid may negatively affect the vital organs of the body, such as: the kidneys, brains and heart.

 

10. Dry mouth and dry eyes: people with lupus may develop Sjogren’s syndrome, which causes malfunctioning of the glands of saliva and tears and end up with dry mouth and eye.

 

Lupus Butterfly Rash:

 

It is a prolonged disorder in  the immune system, which is called ‘autoimmune disease’ as well.

Lupus rash has several types. Of these types is butterfly rash or as some people name it malar rash or ‘acute cutaneous lupus.’

 

Malar rash (butterfly rash):

Malar as a word is taken from a Latin word ‘mala’ that refers to the cheekbones and nose. Malar rash, which forms on the cheekbones and nose, accompanies lupus erythematosus. It’s also linked with other diseases such as: pellagra, dermatomyositis, and Bloom Syndrome.

Butterfly rash is red or purple spots on the cheekbones and bridge of the nose, and it takes the shape of a butterfly as the name suggests. In addition to cheeks and nose, malar rash may extend to reach other parts of the face like the forehead for example.

Generally speaking, butterfly rash is neither painful nor itchy; yet, it may get worsened through excessive exposure to sunlight.

 

Signs and symptoms of malar rash:

  1. Reddish or purplish patches on cheek and nose, this is in case of mild rash.
  2. Formation of scales on the infected areas of the face, this is in case of severe rash.
  3. Fatigue for unknown reasons.
  4. Pain, swelling and stiffness in joints due to damages butterfly rash causes to tissues and skin.
  5. Inflammation of the glands and infection of the kidneys and urinary tract.
  6. High temperature due to pain caused by rash.
  7. Neurological disorders, such as: convulsion, confusion and seizures.

 

Diagnosis of butterfly rash:

Symptoms of Malar rash infection are similar to those of other diseases; that’s why, the diagnosis of the disease is somehow difficult, unfortunately. Here are some measures taken by doctors to diagnose malar rash:

  1. Blood tests.
  2. Urine tests.
  3. Biopsy of the kidney.
  4. Get some information about the patient’s medical history.
  5. Advanced medical tests, such as: X-ray of the face, neck or chest; C-reaction protein test; anti-nuclear antibody test; ANA, and Erythrocyte Sedimentation Rate test.

 

What you want to know also about Malar rash?

Malar rash is highly linked with Systematic Lupus Erythematosus; that’s, about 50% of people with lupus have butterfly rash.

Butterfly rash and other symptoms are the result of tissue inflammation on various parts of the body.

The appearance and severity of butterfly rash differs according to individuals and types.

Normally, malar rash takes the color of red or pink; however, it may turn darker in the sun.

The redness of the cheek resulted from malar rash might be a reflection of other diseases or disorders; for example, rosacea, windburn, scarlet fever, dermatomyositis and pellagra.

 

Causes of butterfly rash on face:

First: Systemic Lupus Erythematous (SLE): It’s an autoimmune disease that causes damages to one’s body’s cells, tissues and organs as well as their functions. Of those organs that are mostly affected by butterfly rash are: the kidneys, heart, brain, lung, liver, blood vessels, tissues, joints, skin and nervous system. But, what causes SLE exactly is still unknown. Yet, some researchers and experts refer it to genetic and environmental factors.

Both genders are prone to get infected, it’s females who are more prone to get infected  than males regardless of their age, whether children, youth or even old. As for females, they are vulnerable to get infected at any age, especially 14-44.

Second: Bloom Syndrome: This syndrome leads to abnormalities in the pattern of chromosomal arrangement in one’s body. Of the multiplications result from this syndrome is butterfly rash on face.

Third: Lyme disease: Principally, it’s caused by mice’ ticks and ends up with bacterial agent namely ‘Borrelua burgdorferi’ that mainly affect the eyes, heart, nervous system, musculoskeletal system and the skin. Of this disease’s effects on the skin is butterfly rash.

Forth: Erysipelas: There’s a bacterial agent namely ‘Streptococcal’, which causes acute allergy of the skin that leads to malar rash on face.

Fifth: Seborrhea or Seborrheic Dermatitis: This chronic disease causes scaling of the skin, dandruff formation of the hair, and skin rashes like butterfly rash on face.

Sixth: Dermatomyositis: This disease is one of the major causes of malar rash. In addition to skin and muscular inflammation.

Seventh: photosensitivity:  It’s associated with excessive exposure to harmful rays of the sun, which leads malar rash.

 

Symptoms of butterfly rash:

The level of infection of this rash varies between being mild and severe. Undoubtedly, each level differs in symptoms.

When it’s mild, you just notice redness on cheekbones; exactly like redness made by blusher. However, in case of severe butterfly rash, very red spots appear over the cheekbones and the bridge of the nose taking the shape of a butterfly. Generally, in both situations, butterfly rash is prone to get much worse or disappear.

Another sign of being infected by butterfly rash is fatigue; yet the reasons for which is still unknown. Due to its harmful damages on the connected tissues of the skin, butterfly rash also causes pain, stiffness, and swelling in the body’s joints. Malar rash is also signaled by the inflammation of one’s glands, such as the thyroid.  In addition to the infection of the kidneys and the urinary tract.

Some neurological disorders, such as: confusion, seizures, and convulsion, are other signals of severe malar rash.

Fortunately, butterfly in most cases doesn’t cause itchiness; however, in specific cases, a patient with butterfly rash may experience sensation and heat.

It’s worthy to mention that butterfly rash doesn’t only appear on the cheekbones and the nose, but it also affects other parts of the body such as: forehead, and neck.

The symptoms of mala rash, when it’s mild, fade away within a week. While, it takes a month to fade away in case of severe level, it might leave a mark on the face even after being fully treated.

 

Treatment of butterfly rash:

Because the face’ skin is very sensitive in nature, consulting a dermatologist is essentially necessary. Here are some of medicines prescribed by experts:

  1. Sunscreen lotions: this for those whose skin is too sensitive to the harmful rays of sun.
  2. Steroidal creams: it reduces the inflammation and itchiness of malar rash.
  3. Drugs: such as anti-malarial and anti-inflammatory drugs.
  4. Avoiding being exposed to sunlight, pesticides, mercury, and silica.
  5. Applying Vitamin E oil, olive oil, cod oil, a pinch of baking soda on the infected area that may reduce irritation connected with butterfly rash.
  6. Following a vegetarian diet.
  7. Taking sufficient portions of sleep.
  8. Drinking plenty of water.

 

 Discoid Lupus Erythematosus:

 

What are the types of Lupus?

First: Acute Cutaneous Lupus ‘Butterfly rash\ Malar rash’:

It’s a skin infection that appears on the cheekbones and take the form of a butterfly, normally, butterfly rash is a reddish or purplish patches, which is usually not painful whether it’s severe or mild. Sometimes, it’s itchy and hot. Butterfly rash is the most obvious and identifiable symptom of lupus. That’s why, a lot of organizations specialized in lupus takes the symbol of a butterfly as their own.

Second: Subacute Cutaneous Lupus:

It has two types:

  1. The first kind is highly sensitive to sunlight that’s why it’s called photosensitivity. As for its look, it seems like small pimples. It is also called a psoriasis-like lesion with red scaly patches that appears on the arms, shoulders, neck, and trunk and few patches on the face. As the rash develops, the pimples get clearer and more obvious. Patients with this kind of rash complain of moderate to severe itchiness associated with rash. Once more, excessive exposure to sunlight gets this rash even worse, and it can appear on face, chest and arms.

 

  1. The second type starts as flat lesions and get bigger turning into red ring-shaped with slight scales on the edges. This kind of rash appears on the face, neck, chest, arms, and back. This rash is itchy and gets worse in the sunlight. After being treated, this rash leaves no scars, but it leaves a non-depressing scars or an area of de-pigmentation where the rash occurred .

 

Third: Chronic cutaneous Lupus ‘Discoid Lupus Erythematosus’:

It’s a group of various continuous autoimmune inflammatory diseases and often affect the skin. It’s worthy to mention that Discoid Lupus Erythematosus is the most common form of cutaneous lupus. Discoid lupus is characterized by: persistent scaly, disk-like plaques on scalp, face, and ears that may cause pigmentary changes, scarring, and hair loss.

 

What is Discoid Lupus Erythematosus?

It’s a group of various continuous autoimmune inflammatory diseases and often affect the skin. It’s worthy to mention that Discoid Lupus Erythematosus is the most common form of cutaneous lupus. Discoid lupus is characterized by: persistent scaly, disk-like plaques on scalp, face, and ears that may cause pigmentary changes, scarring, and hair loss.

 

What are the causes of Discoid Lupus Erythematosus?

  1. Genetic Predisposition.
  2. Exposure to sunlight.
  3. Toxins such as cigarette smoke.
  4. Hormones.

 

Who gets Discoid Lupus Erythematosus?

Generally, both genders are prone to get infected by Discoid Lupus Erythematosus. However, it’s the girls who are 5 times more vulnerable to get infected than men between the ages from 20-44 years. Also, Discoid Lupus Erythematosus is more common than Systematic Lupus Erythematosus. In every 100.000 individuals, 20-40 people are prone to get the infection.

 

Clinical Features of Discoid Lupus Erythematosus:

The majority of people with Discoid Lupus Erythematosus have just involvement of skin infection ‘Cutaneous LE’. Almost, 5%-25% of people with Discoid Lupus Erythematosus develop Systematic Lupus Erythematosus, in which other forms of cutaneous lupus and other organs may develop diseases. SLE symptoms are mild in these patients.

 

Signs of localized Discoid Lupus Erythematosus include:

  1. Initial lesions ‘dry red patches.
  2. Swollen red or hyperpigmented plaques with adherent scale.
  3. Older lesions are hyperpigmented especially on the edge of the plaques.
  4. Scarring results in central loss of pigment ‘white patches’ and skin atrophy ’tissue loss’.
  5. Located on cheeks, nose, ear lobe and concha.
  6. It may involve lips, oral mucosa, nose or eyelids.
  7. Scalp lesions cause temporary or permanent patches of hair loss.

 

Symptoms of generalized Discoid Lupus Erythematosus:

  1. Plaques on anterior chest, upper back, and backs of hands.
  2. Affects palms and soles.
  3. Affect anogenital mucosa.

 

Diagnosis of Discoid Lupus Erythematosus:

Discoid Lupus Erythematosus id often diagnosed through its appearance on sun-exposed sites, as well as the appearance of the plaques. Patients with Discoid Lupus Erythematosus should undergo a through a general examination in order to discover if other symptoms are present or not.

Doctors confirm infection via skin biopsy, in which typical features of Discoid Lupus Erythematosus are found. These features include:

  • Interface and periadnexal dermatitis.
  • Follicular plugging.
  • Atrophy and scaring.

 

Blood Test:

Before diagnosis, doctors ask patients with Discoid Lupus Erythematosus to carry out a blood test.

  1. Full blood account.
  2. Renal Function Test.
  3. Inflammatory markers such as C-reactive protein.
  4. Antinuclear antibody.
  5. Extractable nuclear antibody.
  6. Anti-annexin 1 antibodies: these might be a diagnostic marker for Discoid Lupus Erythematosus.

 

What’s the treatment of Discoid Lupus Erythematosus:

  • Preventive measures:

The following preventive procedures are to protect yourself from Discoid Lupus Erythematosus:

  1. Careful year-round protection from sunlight using clothing, accessories, and sunscreens. Sunscreens only are inadequate.
  2. Indoors: some patients need to stay away from glass windows or these can be treated with UV-blocking film.
  3. Vitamin D.
  4. Smoking cessation.

 

What is the outlook of Discoid Lupus Erythematosus?

Discoid Lupus Erythematosus tends to continue for years or decades. In some patients, all symptoms of active DLE fade away in time.

Squamous cell carcinoma can rarely arise within a longstanding DLE plaque in the skin or mucous membrane. It presents as an enlarging warty growth or ulcer. It is usually treated surgically.

 

Tips and Advice:

Because these rashes are of photosensitivity, it would be better for you to protect yourself from direct exposure to sunlight or fluorescent lights that emits UV radiation. Generally, patients with lupus always experience  photosensitivity, so protecting themselves from harmful sunshine would be of great benefit.

Also, if you have persistent and unexplained rash, you are recommended to see the doctor and take the proper medicine.

Is Discoid Lupus Erythematosus contagious?

Fortunately, neither Discoid Lupus Erythematosus nor any form of Lupus is contagious.

 

Lupus Diagnosis:

 

Lupus is a chronic and difficult disease that hits the autoimmune system. Unfortunately, the symptoms accompanied with lupus is similar to those of other disease, so it’s a little bit difficult to be diagnosed. Additional, there is no single test to be followed to confirm infection of lupus.

Moreover, symptoms of lupus, which are similar to those of other diseases, come and go and need years for a diagnosis to be made.

A doctor can’t diagnose lupus unless he gets a cut clear evidence of the infection whether physical or laboratory. Of these evidences are:

  1. Joint swelling.
  2. Protein in the urine.
  3. Fluid around the lungs and the heart.
  4. Skin biopsy.

 

To conform infection of lupus, doctors use 11 criteria of lupus that are published by the American College of Rheumatology. Of these 11 criteria, four at least must be present to confirm infection. These 11 criteria are:

  • Malar rash: it’s a butterfly-like rash that is formed on the cheekbones and nose.
  • Discoid rash.
  • Photosensitivity: excessive exposure to sunlight.
  • Mouth and nose ulcers: mostly painless.
  • Arthritis: in two or more joints associated with tenderness, swelling, or effusion.
  • Cardio-pulmonary involvement.
  • Neurological disorders: seizures and psychosis.
  • Renal\ kidney disorder: excessive protein in the urine.
  • Hematologic\ blood disorders: hemolytic blood anemia, low white blood cell count, and low platelet count.
  • Immunologic disorder.
  • Antinuclear antibodies.

 

What’s the outlook of people with lupus?

So far, researchers haven’t developed a cure, but every year experts make progress in this field and approach from developing a cure that’s less toxic and more specific. In fifties, people diagnosed with lupus were anticipated to live four years. Nowadays, people with lupus look forward to leading a normal life.

 

A Question and an Answer:

Here are some real questions from people diagnosed with lupus and answers of doctors.

I’m so scared—the doctor just diagnosed me with lupus. What will my life be like?
It is very hard to be diagnosed with a disease that can get better or worse at any point. Living with  lupus means living with uncertainty, and your mind is probably filled with questions.

When will the disease flare?  Will it get in the way of having a family or a regular job?  When will the tiredness stop?

The truth is that no one can tell you what will happen, because everyone with lupus has a different experience. That said, in times of uncertainty, it often helps to focus on things that you can control: how regularly you take your medicines, what you eat, protecting yourself from direct  sunlight.

Use times when you are feeling better to arrange your home and finances in a way that will  make things easier when a flare comes. For example, place lighter kitchen cooking tools where they  won’t strain your aching neck or hands to lift them. Or pre-write bills and address envelopes so that  you can avoid this chore when you’re exhausted.

It’s also your decision whether to find more information and support. The S.L.E. Lupus Foundation and others work hard to make sure that  everyone can learn more about lupus. Support groups meet regularly in many places around the  country and are a lifeline for the hundreds of thousands of people living with this disease. Remember, you are not alone.

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  1. I had a skin biopsy of my face and it came back positive for lupus. I get flare ups all the time, I’m tired and lite headed. My body aches specially after being near the sun. My hand and feet hurt too. I get daily headaches. I get dry mouth and dry eyes. Yet my blood work comes back normal. I am currently using Prednisone for my face and body aches. I don’t know what to think about this anymore. Im going to use this information to ask more questions and more test to my doctor. Let me know what else I can do. Thank you.

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