Doctor insights on:
Treatment Of Rash Discoid Lupus
Why don't men want to go to doctors? My husband has discoid lupus, and I feel I have to drag him in to be seen. What will happen to him without treatment?
Discoid lupus (think singer seal) is seen by itself or with systemic lupus erythematosus (sle). Abut 25% of sle pts have discoid symptoms. If discoid lupus is by itself, 5-10% of them will go on to have sle, but the disease is relatively mild. Discoid lesions are areas of inflammation that go through the dermal layer of skin, causing scarring (like stretch marks). ...Read more
Less sun, some Rx: Sun protection, topical steroids, avoidance of any drug which may have provoked the dle. If no better in 2-4 weeks, cortisone injections into the lesions or topical calcineurin inhibitors. If still no better in 2-4 more weeks, oral hydroxychloroquine, an anti-malarial medication. There are even further treatment for refractory cases but the above usually works. ...Read more
Is it true Hydroxychloriquine is not indicated in the treatment of Discoid Lupus for flare up? And in fact long term use is only indicated for SLE?
According to drugs. Com Hydroxychloriquine is used for SLE and Rhematoid Arthritis.
As you know it is also used for Malaria treatment.
Doctors can prescribe medications what is called off label. They may have seen improvement and know from experience that the medication is safe and effective.
Hope that is helpful to you.
Dr Lori Lange ...Read more
What is lichenoid lupus erythematosus? How is it different from discoid lupus erythematosus? Best course of treatment that does not involve oral meds?
Oral agents best: Lichenoid lupus refers to a specific type if rash sometimes photosensitive, which is oftern red and raised. It occurs between the dermis and epidermis under the microscope. Discoid may also start as a red area but will cause atrophy and scarring. The best treatment is usually the oral agent plaquenil (hydroxychloroquine). Other options include sunscreen, moisturizers and topical steroids if the areas are small. ...Read more
What is the description, conditions, symtoms, risk factors & treatments assocated with discoid lupus?
Discoid Lupus (DLE):
DLE is a chronic cutaneous autoimmune skin disorder characterized by DLE cerythematous-to-violaceous, scaly plaques with prominent follicular plugging that often results in scarring and atrophy (see the images below). DLE may occur in the absence of systemic disease, or it may occur in association with systemic lupus erythematosus (SLE). Read this:emedicine. Medscape. Com/article/1065529-overview
Not Fair: Every person is a different element that we have to figure out what works best for your body. You might have to try a few different medications before you find which works best for you! Don't give up after just one med doesn't work. What works for one patient might not for another with the same condition. It's what makes us unique and what makes being a doctor so confusing. ...Read more
Lupus: Discoid lupus erythematosus (dle) is a chronic skin condition of sores with inflammation and scarring favoring the face, ears, and scalp and at times on other body areas. These lesions develop as a red, inflamed patch with a scaling and crusty appearance. The center areas may appear lighter in color with a rim darker than the normal skin. Discoid lupus can be divided into localized or generalized. ...Read more
Dermal skin injury: Discoid lupus (think singer seal) is seen by itself or with systemic lupus erythematosus (sle). Abut 25% of sle pts have discoid symptoms. If discoid lupus is by itself, 5-10% of them will go on to have sle, but the disease is relatively mild. Discoid lesions are areas of inflammation that go through the dermal layer of skin, causing scarring (like stretch marks). Sometimes mistaken for psoriasis. ...Read more
Yes, but you need to confer with doctors first. Discoid on occasion can transition to systemic lupus so you would want to get checked. Also you would need to have medications reviewed with your doctor. Plaquenil (hydroxychloroquine) is safe in pregnancy, but if you are on medications such as methotrexate, these would have to be stopped long before any attempts at conception are made.
See your doctor to talk more. ...Read more
No: There are none other than using sunscreens. ...Read more
Your personality: Discoid lupus is a relatively benign disorder and can usually be treated with medication. Different people have different reactions to a diagnosis and their responses vary as with any other life event. If your concern is about being a patient with dle, you should consider yourself fortunate that you do not have a more serious illness. ...Read more
Does chronic cutaneous discoid lupus eryhermyosolus turn systemic if you have positive ANA 1:1280 normally.
Should people diagnosed with sle or discoid lupus avoid taking the drugs associated with drug-induced lupus?
If possible: Certain drugs can affect lupus so if there is a choice it may be prudent to avoid three drugs however depending on your circumstance there may not be other options. If you must take a drug associated with lupus be vigilant in reporting any joint pains, fever, or unusual symptoms to your doctor. ...Read more
Yes: Any dermatologist can manage, but not cure, common discoid lupus. You already know to avoid sunlight. Topical or intralesional glucocorticoids have been standard for decades. Systemic Chloroquine or a similar drug are often helpful as well. Topical calcineurin inhibitors are a relatively new addition, and there are reports of success with topical retinoic acid derivatives. ...Read more
Exam is best: The sores with pale center and dark rim, uneven scales / crusts are usually easy to diagnose on physical exam by a general physician; any dermatologist can make the call easily. If there is doubt, punch biopsy shows distinctive features to the pathologist that will remove any doubt; both a standard stain and a "lupus band test" may be performed. Dle is usually manageable but not curable. ...Read more
Common skin dz: This is a very familiar skin disease that may occur by itself or with the far more severe systemic lupus, though the vast majority of dle patients never get sle. The disease can look bad and may produce surface scars. Sun avoidance / screens and topical glucocorticoids generally keep it at bay; systemic antimalarials can help. ...Read more
Scarring rash: Lupus affects in the skin in discoid lupus and in some cases of sle. There is redness usually on the cheeks, nose, possibly ears and scalp. It can show broken blood vessels, depressed scars, and a purple border. Topical or injections of steroids are often helpful. In more severe case oral antimalarials are used. ...Read more
Skin only: Discoid involves skin only but 5 per cent have systemic lupus which can affect almost any organ with common involvement as arthritis, swelling, and in severe cases heart, lungs or kidney. S you must be monitored to rule out systemic involvement and minimize scarring and color changes on the skin. ...Read more
Pets & discoid lupus: The only connection between having a pet and discoid lupus is that if you need to take your pet out for walks, you need to use an excellent sunscreen and a hat, as discoid lupus can become worse with sun exposure. 10% of people with discoid lupus have systemic lupus. Sun protection and avoidance is even more important. Other than that, enjoy your pet! No reason not to have one. ...Read more
Several Rx's!: Discoid in some patients is easy to manage and in others hard. One thing the pt. Can do is avoid uv light. I typically put pts on Hydroxychloroquine @ 6mg/kg of body weight, and use Methotrexate subcutaneous 20-25mg/wk. I occasional add ridaura. Some patients do well with azathioprine. Others do well with cellcept (mycophenolate mofetil). Topical steroids and oral steroids are always options. ...Read more
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