What is Discoid lupus erythematosus (DLE) / Lupus Erythematosus Chronicus Discoides?
Discoid lupus erythematosus is an autoimmune disease that targets the skin and occurs in genetically predisposed people. It is a disease that affects the skin especially that of a face with characteristics of wasting and scarring and marked photosensitivity. DLE presents a rash or lesions on the face and hands. The rash usually aggravates with exposure to sunlight. Hair loss and changes in skin colour are also witnessed.
The skin lesions of DLE are present in a round, slightly raised from the surface. The lesions are initially reddish and are covered by scales. Scales get thickened with colour changes. The centre of the lesion is light-coloured whereas the borders of the scales are darker, as the lesions grow they merge. The result of these skin lesions is wasting and scarring of the skin.
Who is prone to Discoid lupus erythematosus (DLE) / Lupus Erythematosus Chronicus Discoides?
Most common in women between the ages of 17 to 40 years. Women are more affected than men.
It is more common in African Americans than Asians or Caucasians.
What is the classification of Discoid lupus erythematosus (DLE) / Lupus Erythematosus Chronicus Discoides?
• Localized discoid lupus erythematosus: In localized discoid lupus erythematosus, the head and neck are involved and are treated if given proper timely treatment.
• Widespread discoid lupus erythematosus: In this other part of the body are also affected. A person with widespread discoid lupus may have chances to develop systemic lupus erythematosus and it is difficult to treat.
• Hypertrophic discoid lupus erythematosus: The lesions are wart-like mainly on the back of arms. This type is very difficult to treat.
What are the causes of Discoid lupus erythematosus (DLE) / Lupus Erythematosus Chronicus Discoides?
• Family history.
• Cigarette smoking.
• Any alters in DNA in the skin.
• Environmental factors like sun or virus.
• Immune complex formation.
• Stress.
What are the signs and symptoms of Discoid lupus erythematosus (DLE) / Lupus Erythematosus Chronicus Discoides?
• Skin discoloration or scars.
• Rapid breathing.
• Irregular heartbeats.
• Blue or pale lips.
• Inability to urinate.
• Fast heart rate.
• Painless mouth ulcers
• Joint pains with swelling
• Chest pain
• Headache
• Tiredness
• Anemia
• Convulsions
• High blood pressure
• Fatigue
• Weakness
• Weight loss
• Skin rash, butterfly rash over nose and cheeks
• Brittle hair or hair loss
• Red sore dry eyes
• Nausea, vomiting with abdominal pain
• Photosensitivity
• Headache, migraine, seizures, stroke
• Muscle pain and stiffness.
• Sleep disorders
• Thought and concentration disturbance
• Raynaud’s phenomenon
• Sun sensitivity
• An itchy and small swelling on the skin.
What is the investigation advised in Discoid lupus erythematosus (DLE) / Lupus Erythematosus Chronicus Discoides?
• Complete case history.
• Complete blood count.
• Renal/liver function test.
• Erythrocyte sedimentation rate (ESR).
• Antinuclear antibody test (ANA).
• Anti-dsDNA.
• Biopsy.
• Syphilis test.
• Urinalysis.
• Rheumatoid factor.
• Echocardiogram.
• Other antibody tests.
What treatment is advised in Discoid lupus erythematosus (DLE) / Lupus Erythematosus Chronicus Discoides?
• Anti-inflammatory drugs
• Non-steroidal inflammatory drugs (NSAIDs)
• Anti-malaria drugs
• Corticosteroids
• Immune-suppressing drugs
• Cytotoxic
• Gamma globulins
• Physiotherapy as an alternative treatment.
• Psychiatric counseling.
What is the prognosis of discoid lupus erythematosus (DLE) / Lupus Erythematosus Chronicus Discoides?
The prognosis is good if early treatment is done it may reduce scarring or atrophy. Pain may persist along with disfiguration from scars and atrophy which would be permanent.
What are the complications of Discoid lupus erythematosus (DLE) / Lupus Erythematosus Chronicus Discoides?
• Systemic lupus erythematosus (SLE)
• Malignant degeneration ( basal cell carcinoma or squamous cell carcinoma (SCC))
• Depigmentation.
What is the differential diagnosis of Discoid lupus erythematosus (DLE) / Lupus Erythematosus Chronicus Discoides?
• Systemic lupus erythematosus (SLE)
• Plaque psoriasis
• Actinic keratosis
• Warts
• Sarcoidosis
• Syphilis
• Dermatomyositis
• Lichen planus
What is the diet and management of Discoid lupus erythematosus (DLE) / Lupus Erythematosus Chronicus Discoides?
• Take proper rest.
• Avoid going in the sun.
• Use SPF-15-50 depending on the skin.
• Practice yoga and stress management techniques.
• Education about lupus and self-care.
• Regular eye examination.
• Avoid going in the sun.
• Regular moderate exercise.
• Wear protective clothing and headgear when going out.
• Keep away from people who have known infection.
• Quit smoking.
• Avoid alcohol.
• Maintain a healthy diet.
• Eat much of antioxidant-rich foods.
• Vitamin D supplements help a lot.
• Avoid coffee or caffeine-containing ingredients.
• Maintain a good hygiene level.
• Join the support group.
• Counseling by a psychiatrist for depression, or if overstressed.
• Take proper medicine and maintain a proper chart of medication.
• Preventive heart care.
• Regular immunization.
What are the commonly indicated Homeopathy remedies for Discoid lupus erythematosus (DLE) / Lupus Erythematosus Chronicus Discoides?
Arsenicum Album
Apis Mellifica
Hydrocotyle Asiatica
Thuja occidentalis
