Discoid Lupus: Symptoms, Diagnosing, Treatment and Support

Discoid lupus is a benign type of lupus that affects only the skin and sometimes (minimally) the body's joints.

It's caused by the same autoimmune dysfunction as systemic lupus (SLE), but doesn’t affect any internal organs, so the issues of lupus cerebritis, lupus nephritis and other systemic lupus problems generally do not occur.

Although having discoid lupus affects one’s life, it’s not considered a “serious” or “life-threatening” disease, so it receives less attention.

Discoid lupus is characterized by a raised, red rash that can appear anywhere on the body, but commonly affects the face, scalp, neck and chest. It can be itchy, scaly or flaky and frequently appears on the skin after sun exposure. (UV and fluorescent lighting can have the same effect.) It takes a round or oval shape, giving it the name discoid, meaning “round”. See skinsite.com for an example of what a discoid rash can look like.

The rash is usually the only symptom that a patient displays. While there may be minimal joint stiffness or achiness, the degree of extreme pain and immobility that is common among people with SLE is not reached.

ANA levels, RA levels and other blood work usually employed in getting a SLE diagnosis are decidedly unhelpful in diagnosing discoid lupus. (Bear in mind that diagnosing any type of autoimmune disease is not an exact science.) A biopsy of the rash is the only way to make definitive diagnosis. This biopsy can be taken in a dermatologist's office, under local anesthesia.

When the rash appears on the scalp, it can cause patchy, localized hair loss (alopecia). The rash appears underneath the hair and the inflammation causes the hair follicles to lose their hold on the hair. The irritation of the remaining hair rubbing on the rash can cause more inflammation, create scabs and even a little bleeding. Discoid lupus can also cause some generalized hair loss, just as SLE does.

Treatments and Support for Discoid Lupus Patients

It is estimated that only 10-15% of people who suffer from discoid lupus will eventually develop SLE. These estimates are a little inaccurate, since people may be mistakenly diagnosed with discoid lupus when they are in the early stages of SLE. The absence of systemic symptoms such as vasculitis, pleuritis or other internal connective tissue inflammation, as well as negative blood results usually indicates that the lupus is confined to the skin.