Our immune system is designed in such a way that it normally fights off dangerous infections and bacteria to keep the body healthy. But there are certain instances when the body gets hit by an autoimmune disease, more so the immune system attacks the body because it confuses the elements and processes of its own body for something foreign and starts to fight against it. Lupus is a chronic autoimmune disease of unknown cause that can affect virtually any organ of the body. This may occur at different stages of life. Among all forms of lupus, SLE is the most common type and has worsened symptoms that alternate with periods of mild symptoms. Though people with lupus can live a normal life with treatment, in some cases when this ailment worsens, they may need specific treatment and dietary restrictions. There are different types of lupus and one that primarily affects the skin, or the cutaneous membrane is Cutaneous Lupus Erythematosus. More than two to three times more frequent than SLE, not only it makes the skin sensitive to sun exposure, but it also causes many small and big skin problems that may be difficult to treat. In some cases, upon worsening, it may cause immune system damage.
CSLE Main

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Symptoms

Symptoms of CLE can change over time, yet some common symptoms include:

  • Lesions on the skin
  • Discoloration of the skin
  • Thick and scaly patch on the upper layer of skin
  • Extreme sensitivity to the sun- even slight exposure causes severe damage
  • Canker sores - ulcers on the inside of cheeks or under the tongue
  • Butterfly rash- a rash on the cheeks and nose
  • Mild to severe hair loss
  • Hives- raised and painful bumps on the skin

Types Of Cutaneous Lupus Erythematosus

Cutaneous lupus Erythematosus is divided into the following types and subtypes:

Acute Cutaneous Lupus Erythematosus

It typically presents itself in the third decade of life.  ACLE is frequently associated with active SLE and can be typically identified with a butterfly rash, which refers to erythema that occurs over both cheeks, and extends over the nasal bridge. Sometimes these rashes can be mistaken with acne rosacea and seborrheic dermatitis.

Subacute Cutaneous Lupus Erythematosus

Subacute Cutaneous Lupus Erythematosus (SCLE) develops mainly in young to middle-aged women. SCLE is highly photosensitive, and lesions occur in sun-exposed areas, including the upper thorax, upper back, and the extensor surfaces of arms and forearms.

Chronic Cutaneous Lupus Erythematosus

Chronic cutaneous lupus erythematosus involves the head and neck, particularly the scalp and ears Occasionally, it can occur on mucosal surfaces including the outer surface of lips as well.  DLE further has a few subcategories-discoid lupus erythematosus, lupus erythematosus profundus, chilblain cutaneous lupus, and lupus tumidus.

Causes Of Cutaneous Lupus Erythematosus

While the exact cause of CLE is not known, several factors have been associated with the disease. The disease isn’t linked to a certain gene, but people with lupus often have family members with other autoimmune conditions. Immunologic abnormalities, especially the production of a few antinuclear antibodies are prominent features of this and in fact all lupus forms. More often, exposure to ultraviolet rays, certain medications, some viruses, and chemotherapy. imbalanced estrogen levels (in women), prescription drugs have been identified as the main causes of CLE

How Is Cutaneous Lupus Erythematosus Diagnosed?

To properly diagnose cutaneous manifestations of SLE the physician must first correctly classify the subtype of this illness. CLE diagnosis should be based on the findings of patient history, a physical exam that will check for typical signs and symptoms of lupus, laboratory studies, serology to confirm infections with bacteria, fungi, and viruses, and skin biopsy.  Blood tests, such as antibody tests, renal function tests, a complete blood count, and a urinalysis may also be required in some cases

Treatment Of CLE

Treatment of CLE should be based on the severity and type of cutaneous lupus.  Treatment can vary depending on how the symptoms are, and which parts of the body CLE has affected so far. The goal of treatment is to ease symptoms and prevention of new lesions or deterioration of the present ones. By and large, antimalarials are the first-line systemic treatment for all types of CLE. In fact, it can also be done in pregnancy and pediatric patients Limited disease is typically managed with topical corticosteroids or calcineurin inhibitors. Treatment of cutaneous lupus also consists of patient education on proper sun protection and avoidance of certain drugs. Regular topical application of creams, lotions, and ointments is advised that can reduce inflammation of the skin.  The idea is to limit and prevent the damage besides properly educating the patient on ways of prevention and a long-term follow-up.