Discoid lupus erythematosus (DLE) is a chronic skin condition of sores with inflammation and scarring favoring the face, ears, and scalp and at times on other body areas. SLE affects people of all ages. Females are affected more often than males. Young women represent a large group of SLE sufferers. Lupus is called a multisystem disease because it can affect many different tissues and organs in the body. The autoimmune disease lupus is thought to affect up to 60,000 people in the UK, mostly women. Sometimes lupus can cause disease of the skin, heart, lungs, kidneys, joints, and/or nervous system. When only the skin is involved, the condition is called discoid lupus. When internal organs are involved, the condition is called systemic lupus erythematosus (SLE). People of Afro-Caribbean and Asian origin are more likely to develop SLE than Caucasians.
It is likely that a combination of genetic, environmental, and possibly hormonal factors work together to cause the disease. Scientists are making progress in understanding lupus, as described here and in the "Current Research" section of this booklet. It is not known why this inflammatory reaction begins, but it probably occurs because of some combination of inborn or hereditary predispositions and environmental factors. Recent research suggests that people affected by lupus may have a defect in the normal biological process of clearing old and damaged cells from the body, which then causes an abnormal stimulation of the immune system.
There are many possible symptoms.
- Skin rash
- Muscle aches
- Vomiting and diarrhea
- Kidney problems (protein leak)
- Central nervous system problems
- Blood problems (anemia)
Patients on Plaquenil need eye exams once a year to prevent damage to the retina of the eye and periodic blood work. Closely related drugs (Aralen, Quinacrine) may be more effective but have more side effects. Other drugs, such as Accutane and Soriatane, can also be used.
CLE is treated with relatively lower doses of steroids plus vitamin E and fatty acid supplements. Treatment generally needs to be lifelong, and dogs usually do well on it.
Other drugs called immunosuppressives (including azathioprine and cyclophosphamide) may be used to treat disease affecting the major organ systems and to reduce the amount of steroids required. If you are taking this combination of drug therapy you will have regular safety screening tests, eg blood tests. More information on immunosuppressive treatment is available.
A combination of rest, especially during flares, and exercise for joints and muscles is important and should be supervised by the treating physician and physical therapists.