How To Treat Lupus Rash
The treatment for a lupus rash will depend on its cause, the severity of the skin, as well as the location and type of rash. Treatment should take place under the supervision of a rheumatologist and dermatologist , who will educate you on sun protection, and if necessary, prescribe medication based on your symptoms. The medications may include:
- Corticosteroids: These are topical creams applied directly to the skin. A pill or a corticosteroid injection may also be used to clear a thick patch of skin. Corticosteroids reduce inflammation but can also impair the immune system.
- Antimalarial medication: These medications are used to treat malaria but can also effectively treat a lupus rash. These include hydroxychloroquine and chloroquine.
- Steroid sparing medicine: When applied to the skin, it works in ways similar to a corticosteroid by reducing inflammation of the skin.
- Immune-modifying medications: Methotrexate, cyclosporine, and mycophenolate mofetil work to calm the immune system.
Types Of Cutaneous Lupus
NYU Langone dermatologists can identify the three main types of cutaneous lupus, a chronic skin condition in which rashes or sores typically appear on sun-exposed areas of the body, such as the face, scalp, chest, arms, and legs.
Cutaneous lupus is sometimes diagnosed in people who have systemic lupus erythematosus, an autoimmune disorder that affects joints and organs throughout the body. However, people can develop cutaneous lupus without ever being diagnosed with systemic lupus.
Like systemic lupus, cutaneous lupus is caused by an autoimmune response, meaning the body attacks its own tissues and organs. In cutaneous lupus, the immune system targets skin cells, causing inflammation that leads to red, thick, and often scaly rashes and sores that may burn or itch.
Symptoms may flare up and disappear in unpredictable patterns. Without treatment, flares may persist for months or longer. Exposure to sunlight often triggers rashes and sores and exacerbates breakouts.
Cutaneous lupus may affect people of any age or gender, but its most common among women 20 to 50 years old.
The condition is not contagious, and it is generally not life threatening. However, dermatologists at NYU Langone understand that visible rashes and sores may affect how you feel about your appearance and can help you manage symptoms for the long term.
There are three main types of cutaneous lupus: acute, subacute, and chronic. A person may simultaneously have more than one type.
What Does Lupus Rash Look Like
The following pictures show some of the many different rashes, sores, and other signs of lupus that can develop on the skin.
Youll also see ways that lupus can affect the hair and nails.
Swollen eyelid and swelling around one or both eyes
When lupus affects the skin, swelling can be one of the first signs of lupus. When this patient saw a dermatologist, the doctor immediately began testing for lupus. Treatment for lupus cleared her swelling and redness.
Butterfly rash
Occurring only in people who have lupus, this rash spreads out across the nose and cheeks, often in the shape of a butterfly. This itchy rash often appears after someone with SLE or acute cutaneous lupus spends time in the sun.
Thick, scaly patch of skin
People who have discoid lupus develop these patches. Most patches appear on the face, scalp, or ears, but patches can develop elsewhere on the skin. Without prompt treatment, these patches tend to stay on the skin for a long time sometimes for years.
Dark spots, light spots, and scars
If you have a darker skin tone, the long-standing patches of discoid lupus will eventually clear and can leave behind dark spots , light spots, or permanent scars . Prompt treatment of the thick, scaly patches can prevent spots and permanent scarring.
Mouth sores
Scaly rash on sun-exposed skin
Rash with a ring-like pattern
Light-sensitive skin
Hair loss
Nail changes
The different types of lupus can also cause the following changes to your skin:
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What Is A Lupus Rash
Skin rashes are a common sign of lupus, an autoimmune disease. A butterfly-shaped rash on your face called a malar rash often occurs. This rash reaches across your nose, from cheek to cheek, in a shape that resembles a butterfly.
In addition to the malar rash, lupus skin rashes can appear anywhere on your body. Certain types of lupus cause distinct lupus skin rashes.
Lupus gets its name from the facial rash. Thirteenth-century physician Rogerius Frugardi thought the lupus face rash resembled the markings of a wolfs face or bite. He named the disease lupus, which means wolf in Latin.
How Are Malar Rashes Treated
Malar rash treatment can vary widely depending on the cause. Often, your response to treatment of the underlying condition will confirm your doctor’s diagnosis.
Rosacea
Rosacea can’t be cured, but your symptoms may improve with treatment. Doctors usually prescribe antibiotic creams or other topical medicines. Steroid creams often make the condition worse. Your doctor may prescribe oral antibiotics if your rash becomes inflamed.
Lupus
If you are diagnosed with lupus, you will need to control your exposure to the sun. Steroid injections and topical creams should improve the rash. Your doctor may prescribe hydroxychloroquine, an oral medication that can reduce your immune response.
Skin infections
Infections usually improve rapidly when treated with antibiotics given orally or intravenously.
Pellagra
A person with pellagra will usually improve within two days of beginning treatment with niacin supplements.
Dermatomyositis
There is no cure for dermatomyositis, but medications and physical therapy can help.
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Subacute Cutaneous Lupus Erythematosus
Subacute cutaneous lupus erythematosus is less commonly associated with SLE with approximately 50% having a mild form of SLE. It is thought 2040% have drug-induced SCLE. It comprises 1015% of cutaneous LE presentations. The skin changes are more persistent than those of ACLE.
Skin lesions of SCLE:
- Occur on the trunk and upper limbs, triggered or aggravated by sun exposure
- Present as a psoriasiformpapulosquamous rash or annular, polycyclicplaques with central clearing
- Resolve to leave dyspigmentation and telangiectases, but no scarring.
Subacute cutaneous lupus erythematosus
Intermittent CLE is better known as lupus tumidus, a dermal form of lupus erythematosus.
Skin lesions of lupus tumidus:
- Occur on sun-exposed areas of skin, such as the face, neck, and upper anterior chest
- Present as erythematous, round or annular, papules and plaques with a smooth surface
- Resolve in winter without scarring.
Lupus tumidus
What Medications Can Cause A Lupus Rash
There is a phenomenon referred to as drug-induced lupus that is associated with symptoms similar to systemic lupus erythematosus , which commonly presents as a skin rash. While many medications have been linked to drug-induced lupus, there are a few that have a higher risk, which include:
- Pronestyl , used to treat irregular heart rhythms
- Quinaglute , used to treat irregular heart rhythms
- Nydrazid , used to treat tuberculosis
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What Are The Symptoms Of Cutaneous Lupus
Symptoms of SLE and skin lupus can range from mild to severe and may come and go. They may flare up at certain times throughout your life. Physical and emotional stress, illness, injury and some medications can trigger a flare in people who have lupus.
Signs of skin lupus are similar among all types of the disease, but the rash usually looks a little different with each type. The rashes may be painful and they may itch but not always. They can get better or go away after a few days or weeks. These rashes may be permanent.
Symptoms of skin lupus include:
- Red, scaly areas of skin. They can be round, like a coin or a disk. Darker red rings or borders may outline the scaly patches. They can appear anywhere on your body, but they more commonly develop on areas that have had sun exposure.
- Rash that extends across the cheeks and over the bridge of the nose . About 50% of people with lupus develop this type of rash.
What Causes Cutaneous Lupus
Skin lupus is not contagious . Healthcare providers arent sure what causes lupus. They believe it results from a combination of genes, hormones and environmental factors. Lupus runs in families, and scientists have found more than 50 genes that people with lupus commonly have.
Women are much more likely to get lupus, so providers think the female hormone estrogen plays a role in who develops the disease and when symptoms appear. Symptoms can flare up around a womans menstrual cycle or during pregnancy when estrogen levels are higher.
If you have cutaneous lupus, you can develop a rash when your immune cells cause inflammation in your skin. Symptoms of cutaneous lupus can flare up following exposure to ultraviolet rays. These rays are in both the sun and fluorescent lights. Lupus skin lesions are very sensitive to light. Some medications can also cause a flare of skin lupus.
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Joint Swelling And Pain
One of the most common symptoms of lupus is joint problems. Lupus may cause swollen, tender, stiff, or warm joints.
These issues usually affect the extremities, including the fingers, toes, wrists, knees, and ankles. Although lupus is not a type of arthritis, the inflammation that it causes can result in symptoms of arthritis.
Lupus And Heart Problems
The most common heart problem linked to lupus is an inflammation of the sac around the heart. This may cause severe pain in the left side of the chest. People with lupus are also more likely to develop plaques that narrow or clog the arteries. This can lead to coronary artery disease. Other complications include heart valve disease and inflammation of the heart muscle. Call 911 immediately for chest pain, rather than trying figure out the cause yourself.
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Of Systemic Lupus Erythematosus 1
Systemic Lupus Erythematosus. Systemic lupus erythematosus is the most common form of the autoimmune disease lupus. This red scaly rash on a person’s cheek is typical. SLE affects the skin and other internal organs. It’s possible for the heart, lungs and brain to become involved, followed by the formation of scar tissue . SLE is usually treated with corticosteroids.
Can I Prevent Cutaneous Lupus Lesions
It isnt possible to prevent cutaneous lupus. You may be able to prevent rashes from flaring up by avoiding the sun and limiting your indoor exposure to fluorescent light. To lower your risk of developing lupus skin rashes, you should:
- Avoid being outdoors in the sun when its strongest .
- Protect your skin with sunscreen that has both UVB and UVA protection . Choose clothing that offers complete coverage.
- Wear a hat with a wide brim.
Certain medications can make you even more sensitive to light. Tell your provider about any medications you take so you can ensure that youre protected from the sun. If you smoke, talk to your provider about a plan to help you quit.
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S That Show What Lupus Really Looks Like
May is Lupus Awareness Month, so its especially important during this time to raise awareness and promote understanding of the condition and those who live with it. Lupus is a systemic autoimmune disease in which the body attacks its own tissues and organs. Since lupus can attack just about any part of the body, symptoms may vary widely between individuals, but some of the most common ones include fatigue, joint pain and a facial butterfly rash.
The symptoms of lupus can be debilitating or even life-threatening in some cases but there is so much more to lupus than the physical effects. It can affect just about every aspect of a persons life, from your relationships to your mental health to your ability to attend school/work or do the activities you enjoy.
In honor of Lupus Awareness Month, we asked our Mighty community to share a photo that represents an aspect of their life with lupus they wish others understood. This month especially, lets elevate the voices of those who live with lupus so loved ones as well as researchers and medical professionals have a better understanding of this condition.
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Heres what our community shared with us:
1.26 years old with lupus SLE and scleroderma taken during some hospital stay, for some random flare last year. Brenda T.
2.This one after one of my surgeries that are needed for pain relief and mobility! Denise H.
Read more stories like this on The Mighty:
A Closer Look At Lupus
Understanding lupus
Lupus is an autoimmune disease that affects more than 1.5 million Americans, according to the Lupus Foundation of America. Normally, the immune system protects the body against foreign invaders like viruses and bacteria. In the case of a disease like lupus, the immune system mistakenly attacks the body and damages healthy tissues and organs. Lupus can cause problems with the kidneys, nervous system, blood vessels, and skin.
There are different types of lupus, each of which cause different symptoms. Systemic lupus erythematosus is the most common type. It affects many different organs of the body, including the kidneys, lungs, brain, and arteries.
Cutaneous lupus erythematosus affects the skin.
Neonatal lupus is a rare condition in pregnant women that causes the baby to be born with a rash, liver problems, and sometimes a heart defect.
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What If I Get Malaria Anyway
If you have symptoms of malaria, get help at once. Itâs important to start treatment as soon as possible before it gets more severe.
Your doctor will try to decide what type of malaria infection you have in order to figure out which drug you should take. This is important, as some malaria parasites have become resistant to certain drugs. Your doctor may prescribe a combo of malaria medications to help you avoid this drug-resistance problem.
The type of drug youâre prescribed will depend on several things, including:
- The type of malaria infection you have
- Whether you took medicine to prevent malaria and, if so, what kind
- Whether youâre pregnant
These drugs may be swallowed or taken through an IV line for people with severe cases.
Many of the medicines used to treat malaria are the same ones listed above for preventing it. You shouldnât take the same medicine to treat malaria that you took when you were trying to prevent it.
Show Sources
CDC: âMalaria: Frequently Asked Questions.â âWhere Malaria Occurs.â âMalaria Risk Assessment for Travelers.â âAbout Malaria.â âChoosing a Drug to Prevent Malaria.â âMalaria Information and Prophylaxis, by Country.â âMalaria Parasites.â âChoosing a Drug to Prevent Malaria.â
MedlinePlus: âMalaria.â
Talking To Others About Lupus
Others wont be able to see most of the symptoms caused by your lupus. When symptoms like pain, fatigue, depression, or joint stiffness make your regular tasks more difficult, its important to know how to talk to those around you.
It may help to start by explaining what lupus is not. Let people know that is not contagious, nor is it like cancer or HIV or AIDS. Then explain what lupus is. Let them know that it is chronic, which means you will have it forever, and that it affects each person differently.
Your conversations with others about lupus may change depending on who you are talking to.
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Protect Your Skin From Ultraviolet Light
Most people with lupus are sensitive to UV light and it can trigger lupus skin problems. Follow these tips to protect yourself:
- Use a broad-spectrum sunscreen with SPF 60 or higher that blocks both UVA and UVB rays. Use a wax-based lip balm with SPF 15 or higher to protect your lips. Apply sunscreen at least 20 minutes before sun exposure and apply throughout the day.
- Wear long sleeves, pants, and wide-brimmed hats made of fabrics that protect you from the sun
- Plan outdoor activities for early in the morning or later in the evening. Its also important to remember that cloud cover or shade doesnt fully protect you from UVA rays.
You may be sensitive to indoor lighting, too. If indoor light bothers you, try putting light shields over fluorescent bulbs. You can also buy light bulbs that send out low amounts of UV radiation, like LED lights. If the sunlight bothers you while indoors, its possible to get UV-blocking shades for your windows to prevent sunlight from entering the room.
How Can I Prevent A Lupus Rash
Lupus treatments like immunosuppressants can keep the disease in check, lowering your risk of developing a lupus rash. You can also take these steps to protect yourself from light exposure:
- Apply a broad-spectrum, SPF 30 sunscreen daily even when indoors. Reapply sunscreen every four hours.
- Avoid going outside when the suns rays are strongest, between 10 a.m. and 4 p.m.
- Wear a wide-brimmed hat , tightly woven clothes, long sleeves and large sunglasses when outdoors.
- Dont use tanning beds.
- Use lower-intensity lightbulbs at home and ask your employer to install them at your workplace.
- Put up UV-protective window coverings at home and work.
- Apply UV-protective window films to your car windows. .
- Move your workspace away from windows.
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