Discoid lupus erythematosus (DLE) is an autoimmune disorder characterized by the appearance of coin-shaped lesions on the skin, especially on the face and neck. This condition appears to be caused by an immune reaction in which the immune system attacks the skin, mistaking it for a hostile invader. Up to 10% of patients with this condition can go on to develop systemic lupus erythematosus (SLE), which is accompanied with much more severe symptoms as the immune system widely attacks the body's tissues.
There appears to be a familial link in the development of discoid lupus erythematosus, with people who have a family history of the condition being much more likely to develop it at some point in life. The condition also tends to involve women more than men, with women being about three times more likely than men to develop DLE, and it typically onsets in the 30s, although children can also develop discoid lupus erythematosus. Childhood onset appears to be evenly distributed between boys and girls.
The lesions in the skin can vary in size and shape, depending on the patient, with the center of the lesions tending to be lighter. They tend to be noticeable because they are commonly located on the face, scalp, and ears, which makes them hard to miss. The lesions will become inflamed and irritated, typically becoming crusty and scabby, and some patients develop scarring. Photosensitivity is a common problem for patients with discoid lupus erythematosus, who may find that their skin becomes easily irritated in sunlight.
The immediate treatment for this condition is cortisone cream or cortisone injections. If the lesions persist, a doctor may recommend stronger medications which are designed to address skin inflammation. Certain medications may require follow up care to confirm that the patient is not developing harmful side effects such as vision problems. The patient may also be advised to wear sunscreen and protective gear such as sun hats and sunglasses if he or she has developed photosensitivity.
Because discoid lupus erythematosus can sometimes lead to systemic lupus, doctors may also recommend that patients with this condition receive regular checkups and evaluations. Patients should also report unpleasant side effects or any health problems to their doctors so that signs of SLE can be identified early, if it does emerge. Patients with DLE may find it necessary to discuss their condition with coworkers, employers, or teachers because of the highly visible discoid lupus rash, and they should stress that the condition is not contagious and that they are receiving the appropriate treatment.
