Cutaneous Lupus Erythmatosus

Cutaneous Lupus Erythmatosus

Cutaneous Lupus Erythmatosus

Lupus Erythematosus  (LE) of the skin comprises an uncommon group of skin disorders. LE most often affect young adult women (aged 20 to 50) but children , the elderly and males may be effected by this disorder.

CAUSES

It is classified as an Auto Immune disorder, as it is associated with antibodies directly against components of the cell nuclei. Lupus may affect any tissue, but skin manifestations are more common. These are usually provoked by sun exposure. It tends to be more severe in smokers.

There are many types of Cutaneous  Lupus Erythmatosus

  • Discoid Lupus Erythmatosus
  • Subacute  Lupus Erythmatosus
  • Lupus Erythematosus Tumidus
  • Lupus Profundus
  • Neonatal  Lupus Erythmatosus
  • Cutaneous Lupus Mucinosis
  • Chilblain Lupus Erythmatosus
  • Drug Induced Lupus Erythmatosus
  • Systemic Lupus Erythmatosus (SLE)

DISCOID  LUPUS  ERYTHMASOSUS  (DLE)

  • It predominantly affets the cheeks , nose and ears , sometimes the upper back , V of neck , back of hands may also involve.
  • Hypertropic LE results in thickening and warty skin resembling viral warts or skin cancers.
  • Palms and soles are least affected areas of LE
  • Scalp may also be involved , if the hair follicles gets involved , they first plugged with adherent scale and then bald areas can develop. If the follicles are destroyed , the bald patches are permanent ( Scarring Alopecia )
  • DLE may effect the lips and inside the mouth causing ulcers and scaling. These  lesions may predispose to SCC , squamous cell carcinoma.

SUBACUTE LUPUS ERYTHEMATOSUS

  • It is a non itchy rash appears on the upper back and chest , often following sun exposure.Subacute LE doesn’t scar.It includes the following features.
  • Annular or Polycyclic (Ring Shaped)
  • Papulosquamous ( Scaly Bumps)
  • Vasculitis ( Purple Spots)
  • Nodular ( Lumps)
  • No significant systemic features .

LUPUS TUMIDUS

  • Lupus  Erythematosus Timidus  have rashes mainly at the sun exposed areas
  • Photosenstive areas  are generally effected
  • Presentation is red swollen , urticaria like bumps and patches.
  • Some lesions may be ring shaped or annular
  • Tends to clear during winter season and doesn’t leave any scar.

LUPUS PROFUNDUS

  • This type of lupus affecting the fat underlying skin
  • It is also called Lupus Panniculitis
  • It may develop at any age including children.
  • The face is the most common area to be affected
  • Inflammation of the fats results in firm deep nodules for some months.

NEONATAL LUPUS ERYTHEMATOSUS
The mother who have Subacute LE and the newborn baby born to that mothers amy develop a temporary ring like rashes known as Neonatal LE.
Although the rashes clears within few months , these types of baby usually at the risk of congenital heart block.

CHILBLAIN LUPUS ERYTHEMATOSUS
Some patients have circulatory problems they may get Cutaneous LE like Chilblains ( (Chilblain lupus ), especially if they live where there is cool climate or they are smokers.
They may suffer from Raynaud’s Phenomenon.

CUTANEOUS  LUPUS  MUCINOSIS
The features of this Lupus are non specific .
Papules , nodules , plaques came up on the cheeks , chest ,arms and upper back.
Skin biopsy confirms the deposits of mucin in the dermis.

DRUG – INDUCED LUPUS ERYTHEMATOSUS
Certain medications may rarely cause Lupus. Generally symptoms takes some months to develop. Drug induced lupus does not usually affects the skin. The most frequent medicines are::

  • Hydralazine
  • Phenytoin
  • Carbamazepine
  • Lithium
  • Sulphnomides
  • Minocycline

SYSTEMIC LUPUS ERYTHEMATOSUS (SLE)
Cutaneous LE may be part of an uncommon disease called SLE. Only a few patients with Cutaneous LE also have SLE. The classical feature of SLE is malar eruption or Butterfly rash i.e. red patches across the cheeks. Photosensitvity , mouth ulcers , urticaria and diffuse hair hair thinning are other skin changes.
SLE is a systemic disorder may also effect joints , lungs , liver , brain , blood vessels ( Vasculitis) and blood cells.

AYURVEDIC TREATMENT OF CUTANEOUS LUPUS ERYTHEMATOSUS

  • The basic idea of the treatment for cutaneous LE is to improve the Immune System of the body and get rid from the symptoms.
  • If the patient is taking Nicotine in any form , stop immediately and encourage them to avoid smoking
  • If it is due to the medications – drug induced – stop that medicine.
  • Sun protection is very important , use sun screen to face neck and arms before going to sun. Sun screen moe than 35 SPF is good to protect. Use the cloths that covers the body so that it protects from sun rays .
  • Oral herbal mixtures in the form of Capsules and tablets are very helpful to enhancing the Immune System and it detoxifies the body and removes the toxins form the body.
  • Herbal creams and lotions for the skin to repair the damaged part.
  • Ayurvedic Sun screen lotions are very helpful for protecting form sun rays and are very safe.
  • Panchakarma is the another way to detoxify the body and enhance the Immune System to fight against the diseased cells.
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