Thread: Skin Lupus?
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Old 12-31-2006, 10:17 AM   #2
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Re: Skin Lupus?

Hi, Northmackinaw. A big welcome to you! Lupus has 5 main types. These are SLE (systemic), SCLE (subacute cutaneous), DLE (discoid), DILE (drug-induced), and neonatal.

Have you seen the "sticky posts" at the top of the board? Look at the one with the ACR (Am. College of Rheumatology) criteria for systemic lupus, including symptoms common in SLE. FYI, the other four types of lupus are "subsets" of systemic lupus, meaning the "lesser" types dovetail into the SLE list, but bring fewer symptoms & often variances in test results as well.

RASHES: again, there's variety. Here is some info on the most common rashes. Malar, a/k/a the butterfly rash, is strongly associated with SLE (systemic lupus). In SCLE (subaute cutaneous), which is thought to be an intermediate form falling between SLE & DLE, two other rashes are the typical ones: one is psoriasiform (it looks like psoriasis but isn't), and the other is annular (targetlike); both SCLE rashes are generally nonscarring & nondepigmenting. In DLE (discoid), considered milder than SLE and SCLE, rashes tend to scar &/or depigment, and symptoms tend to be mainly skin, perhaps with fatigue & pain, too.

BUT the type of lupus one has is not defined only by the rash, but instead by the *totality* of criteria met over your LIFETIME. For example, if you meet 4 or more of the ACR criteria right off the bat, you could have, right off the bat, either systemic lupus = SLE (or, more rarely, SCLE). But lupus can start with "skin-only", then evolve to more widespread disease. Or something you had in, oh, 1998, could now take on deeper meaning now that you know you're getting some form of lupus rash.

Therefore, if you have *any* lupus-specific rash, by definition, you have some form of lupus. But what form? Well, to play it safe, you may want to be evaluated by a RHEUMATOLOGIST, to be vetted for signs of disease beyond just skin, then treated & monitored accordingly by whichever specialist, rheumie or dermie, better fits your findings.

QUESTIONS: What does your rash look like? Where on your body does it appear? Does it scar or depigment? Do you get sun exposure? Was your rash biopsied to confirm it was lupus-specific?

PLAQUENIL is an antimalarial drug used in milder lupus, where no major organs are involved. If major organs (kidney, heart, lungs, brain, etc.) are threatened, stronger drugs like steroids and immune suppressants are *definitely* needed.

I also got feverish & chilly when my rashes appeared, then I'd feel somewhat better as they faded, then the whole cycle would start all over. I turned out to have the rarer SCLE subset, with systemic problems but (I was lucky) no major organ involvement. I take Plaquenil, avoid sun, and have regular follow-ups with my rheumie (who is a fine dr., the first in my lifelong, absurd history I fully respect & trust).

Anyway, I hope you post back with more about what's going on with you. There's a wide variety of really nice people here, and you'll meet more of them soon, I'm sure. We post a lot here---definitely not a dull group. Bye for now, with best wishes, Vee