discoid lupus erythematosus

The medical community recognizes three forms of lupus erythematosus: systemic lupus erythematosus, sub-acute lupus erythematosus and discoid lupus erythematosus (cutaneous lupus or skin lupus). All forms primarily affect African American females during the childbearing years.

Discoid lupus commonly attacks the scalp, face and ears; occasionally, the arms and hands can be affected, as well. Many cases show that heat is the principle triggering factor; hair dryers, curling irons, and straightening combs are the usual culprits. Heat from the sun can also trigger an eruption.

Discoid lupus may first appear as a tender or itchy spot in any of the affected areas. The spots can be red or dark in color. A biopsy may be necessary to confirm the diagnosis. More advanced forms of the disease can result in bald spots that may be atrophic (areas of the skin where there is loss of color and thinning of the skin). In more severe cases, the skin erodes and the surface becomes raw. 

Once one is diagnosed with lupus, steps should be taken to prevent further progression of the disease. The amount of time spent under a hair dryer should be limited to less than 20 minutes or the dryer should be kept on a warm setting. Care should be taken not to touch the scalp or surrounding skin with a hot curling iron or straightening comb. The sun should also be avoided.

Treatment will depend on the severity of the condition. Topical corticosteroids can help in milder cases. Injections of a corticosteroid directly into the spots may be necessary for more severe lesions. In the worse cases, internal medications may be prescribed.
–dr. wesley s. wilborn