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Patient education: Discoid lupus (The Basics)

Patient education: Discoid lupus (The Basics)

What is discoid lupus? — Discoid lupus is a skin problem that causes raised areas (called "plaques") and scars on the skin (picture 1). Discoid lupus can happen anywhere on the skin but usually happens on the upper body. The most common places for discoid lupus are the face, neck, scalp, and ears.

What are the symptoms of discoid lupus? — The main symptom is pink, brown, or purplish scaly plaques. These plaques tend to slowly expand at the edges and then heal. When they heal, they leave behind discolored skin and sunken scars. Discoid lupus on the scalp can cause hair loss.

Sometimes, people with discoid lupus also have lupus in other parts of the body. This is called "systemic lupus." But most people with discoid lupus just have lupus in their skin.

Should I see a doctor or nurse? — If you are being treated for discoid lupus, see your doctor or nurse if the condition does not improve with the medicine you were given or if it gets worse. Seeing your doctor or nurse right away is important because treating your discoid lupus early can help to prevent more skin discoloration and scars. You should also see your doctor or nurse if you notice new bumps or sores in places where you have discoid lupus.

Is there a test for discoid lupus? — Yes. If your doctor or nurse suspects you have discoid lupus, they can take a small sample of skin from 1 of your plaques and send it to the lab. There, another doctor will look at the types of cells that are present to learn whether you have discoid lupus.

Is there anything I can do on my own to feel better? — Yes. It's very important to protect your skin from the sun. Sun exposure tends to make the skin problems caused by discoid lupus worse. To protect yourself from the sun:

Stay out of the sun in the middle of the day (from 10 AM to 4 PM), when the sun's light is strongest

Stay under a sun umbrella, tree, or other shady spot

Wear sunscreen – Put sunscreen on all parts of the body that are not covered by clothes. Then reapply sunscreen every 2 to 3 hours, or after you sweat or swim. It's important to choose a sunscreen that:

Has an SPF of 30 or greater – SPF is a number that tells you how well a sunscreen protects the skin from UV light.

Protects against 2 types of UV light, called "UVA" and "UVB." (Sunscreens that offer both UVA and UVB protection are sometimes called "broad spectrum.")

Has not expired or is not more than 3 years old

Wear a wide-brimmed hat, long-sleeved shirt, and long pants

Do not use tanning beds

If you smoke, it's a good idea to quit. Discoid lupus seems to be more severe in people who smoke. Plus, smoking seems to make certain medicines for discoid lupus less effective.

If you are bothered by the way discoid lupus looks on your skin, you can use special cosmetic products to make the skin changes less obvious. Both men and women can use these products. Examples are sold under the brand names Dermablend and Covermark. Other products can also be helpful.

How is discoid lupus treated? — Treatments include:

Steroid medicines that come in ointments, creams, or gels – These steroid medicines reduce inflammation and help the skin heal. Examples include fluocinonide or clobetasol.

Medicines called calcineurin inhibitors that come in ointments or creams. Examples include pimecrolimus (brand name: Elidel) and tacrolimus (brand name: Protopic).

Steroid medicines that come in a shot, which is given directly into the portion of skin that is affected.

People who do not get better with the treatments mentioned above can try a different type of medicine. Examples include hydroxychloroquine (brand name: Plaquenil) and chloroquine (brand name: Aralen). If these don't work, there are also other medicines that might help people with discoid lupus.

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This topic retrieved from UpToDate on: Jan 02, 2023.
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