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Old 01-17-2009, 04:28 AM   #5
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Re: My symptoms + Lupus in Family...

JayDee, In lupus (etc.), answers (or at least big clues) are sometimes in the skin. If you can't find a rheumie or GP soon who gets you moving, what about trying a new dermatologist? Meaning, are you 100% sure that your various skin problems have been accurately Dx'ed? Did your drs. perform skin biopsies? And did previous meds/instructions actually help your rashes?

The recurring rash you call shingles: Are these totally separate lesions, in a different location from your plaque psoriasis? Do they itch, burn & sting? Where are they?---on photo-exposed skin? (I'm curious because shingles often cover a somewhat large area; and to respect the center line of the body, meaning limit themselves to right or left side; and to sting/itch.)

I'm asking because, while many drs. recognize a lupus butterfly rash & discoid (scarring) lesions, there are OTHER less-known lupus-specific rashes. For example, two distinct SCLE rashes. FYI, SCLE can be viewed as an intermediate "subset", typically falling between DLE & SLE. Unlike discoid, SCLE rashes tend NOT to itch, scar or depigment. They favor photo-exposed skin. Antibody most often found is anti-Ro. Here's how they differ:

SCLE annular form: Immature lesions are red, raised, non-itchy papules. Over time the papules "morph" into targetlike circles, then lose circularity, then merge together as they expand outward, finally fading without scarring or depigmenting. (I had this one for YEARS on upper arms/torso. A local dermie saw my rash in late stage, all spread out & merged; and he suspected *plaque psoriasis*---which didn't fit, because my skin didn't itch, flake, etc. Over time, sun made my rashes more widespread & morefrequent, instead of better. Other local dermies suspected Lyme, drug reactions, flea bites, etc. In contrast, a smarter big-city dermie knew exactly what to test for first.)

The other SCLE rash is called SCLE psoriasiform or papulosquamous: This one looks like psoriasis (but isn't). Likewise, it doesn't itch, scar, etc. It sometimes goes more widespread, I *think* (face, lower body, etc., in addition to arms/back).

You could find lupus hardcovers by reputable authors in your library. Dr. Daniel Wallace is a top choice; also Dr. Robert Lahita. Go straight to the skin chapter & see if anything rings bells. Of course, I'm ONLY a patient, but your skin comments made me curious. You've gotta be frustrated! (I was, too!) With my best wishes to you, Vee