Skin Care and Lupus

from Lupus : A Patient Care Guide

Skin problems are very common in people with lupus. Some skin rashes and sores (also called lesions or ulcers) are very specific to lupus, while others can occur in other diseases as well. A sensitivity to and too much exposure to the ultraviolet (UV) rays of sun and some types of artificial light are responsible for aggravating some rashes and lesions. Many types of skin conditions are common in lupus.

Butterfly rash: This rash over the nose and cheeks can range from a faint blush to a rash that is very severe, with scaling. It is very sensitive to light and appears to gets worse when skin is exposed to sun or certain types of artificial light. The rash may be permanent or may come and go.

Discoid lesions: These scarring, coin-shaped lesions are seen on areas of the skin that have been exposed to UV light. They may also occur on the scalp and produce a scarring, localized baldness that is permanent.

Subacute cutaneous lesions: These nonscarring, red, coin-shaped lesions are very sensitive to UV light. They can appear scaly and can mimic the lesions seen in psoriasis. They may occur only on the face or cover large areas of the body.

Mucous membrane lesions: Mouth ulcers are sometimes seen in lupus patients. Nose and vaginal ulcers may also occur. These lesions are usually painless.

Hair loss: In addition to losing hair because of discoid lesions, some lupus patients may develop a temporary, generalized hair loss followed by the growth of new hair. Hair loss may also be caused by infection or by use of corticosteroids or other lupus medications. A severe lupus flare could result in defective hair growth, causing the hair to be fragile and break easily.

Vasculitis: This is a condition in which the blood vessels become inflamed. Very small blood vessels can break and cause bleeding into the tissues, resulting in tiny, reddish-purple spots on the skin known as petechiae (pe-teke-ee-ah). Larger spots are called purpura and may look like a bruise. Vasculitis can also cause blood clots to form, skinulcers to develop, and small black areas to appear around fingers and toenails. These black areas are a sign of serious tissue damage. If they begin to develop, see your doctor immediately.

Raynaud’s phenomenon: This is a condition in which the blood vessels of the fingers and toes react in an extreme way to cold or stress. They suddenly get very narrow (vasoconstrict). This decreases the blood supply going through the vessel. As a result, the fingers and toes become cold and can become pale or bluish. Pain or tingling can occur when the hands and feet warm up and circulation returns to normal.

Drug-induced skin changes: Some drugs used to treat lupus, such as corticosteroids, immunosuppressives, and antineoplastics, can affect the skin. Your doctor or nurse will review these side effects with you if one of these drugs has been prescribed.

Recommended Books:
Coping With Lupus: A Practical Guide to Alleviating the Challenges of Systemic Lupus Erythematosus by Robert H. Phillips, et al.
Lupus: the Facts by Graham R. V. Hughes
New Hope for People with Lupus: Your Friendly, Authoritive Guide to the Latest in Traditional and Complementary Solutions by Sara J. Henry

Source:  National Institute of Arthritis and Musculoskeletal and Skin Diseases, National Institutes of Health, Bethesda, MD 20892, January 1999