What is cutaneous lupus?
Cutaneous lupus is an autoimmune disease that causes skin rashes when your immune system mistakenly attacks your skin cells. Sometimes cutaneous lupus is a sign of systemic lupus erythematosus (SLE), which causes inflammation throughout your body, including your joints, blood vessels, and organs. Other times, cutaneous lupus occurs on its own and only affects your skin.
Cutaneous lupus is a lifelong disease that requires long-term care. Penn Medicine’s dermatologists are specialists in autoimmune skin disease care and can do a thorough evaluation of your skin and symptoms to diagnose lupus of the skin. To treat your condition, our experts use the latest therapies to help calm inflammation and clear the rash.
Cutaneous lupus symptoms
There are three types of cutaneous lupus, each causing a different type of rash. Lupus skin rashes may be pink, red, dark purple, or dark brown, depending on the type of cutaneous lupus and your skin color.
Most people with cutaneous lupus have a chronic form. This type doesn’t go away, but your symptoms may cycle between getting better and then worse. Symptoms often develop after your skin has been exposed to the sun. There are several subtypes of chronic cutaneous lupus, but the most common is discoid lupus, a disease that causes distinct patches on your skin.
Symptoms of discoid lupus include:
- Round, coin-shaped patches of inflamed skin on your face or scalp
- Scars or skin discoloration after the skin lesions heal
- Hair loss from scarring on your scalp
This type of cutaneous lupus usually occurs with SLE and causes rashes and sores that come and go quickly. Symptoms typically appear after sun exposure or during times of stress.
Symptoms of acute cutaneous lupus include:
- A rash across your cheeks and nose in a butterfly shape
- Mouth sores, called canker sores
- Raised, painful bumps, known as hives
- Temporary hair loss
Subacute cutaneous lupus occurs with SLE about half the time. Direct sunlight can trigger a rash on your chest, neck, back, or arms, but not your face.
Symptoms may include:
- Raised, scaly skin in the shape of rings
- Bumps with scaly skin
- Areas of lighter skin after the rash has healed
Causes of cutaneous lupus
As an autoimmune disease, skin lupus is caused by your immune system mistakenly targeting your skin and causing inflammation. A combination of gene changes and something in your environment, like sun exposure or long-term use of certain medications, leads to the disease.
Factors that increase your risk of developing cutaneous lupus include:
- Assigned female at birth and between ages 20 and 50
- Being African American
- Having SLE or another autoimmune disease
- Using certain medications for a long time, like anti-fungal drugs, anti-seizure medicines, proton-pump inhibitors, and others
- Long periods of sun exposure
- Having a serious illness or injury that stresses your immune system
- Smoking
Complications of cutaneous lupus
Reducing your sun exposure helps you avoid flare-ups of cutaneous lupus, but doing so can lead to vitamin D deficiency. In rare cases, having discoid lupus with mouth sores or rashes that last a long time can increase the risk of developing skin cancer. Talk to your dermatologist about what you can do to prevent these complications.
Diagnosing cutaneous lupus
Your dermatologist will examine your skin and ask about your symptoms, health history, and medications. They may recommend blood tests and other tests to make a final diagnosis.
Cutaneous lupus treatment
There’s no cure for cutaneous lupus, but treatments can help clear your rash. An important part of your treatment plan is to protect your skin from the sun by using a broad-spectrum sunscreen with SPF of 50 or higher. If a medication is causing your symptoms, your doctor may recommend changing the drug. There are several creams, ointments, oral medications, and other drugs that can treat skin lupus.
Partners in managing lupus and autoimmune disorders of the skin
Lupus skin rashes can interfere with living your life to the fullest. Penn Medicine’s experienced dermatology team is skilled in diagnosing and treating cutaneous lupus and can help you manage the disease long term. Prompt treatment can help clear your skin and reduce complications like scarring and hair loss. If you also have systemic lupus, our dermatologists work with your other specialists, like your rheumatologist, to ensure your treatment plan addresses all your symptoms.
Penn Medicine is nationally recognized for diagnosing rare and complex skin conditions, and our experts have deep knowledge in autoimmune skin disease care and treatment. Several of our dermatologists serve on boards and committees of national organizations, including the Lupus Foundation, helping to steer research and advocacy for those living with skin lupus.