​Cutaneous Lupus Erythematosus

Cutaneous lupus erythematosus (CLE) is a chronic autoimmune disorder which affects millions of people worldwide, and is a skin-related form of lupus erythematosus (LE).

Lupus is a disorder, where your body’s immune system (the body’s natural defence system) begins to attack its own tissues and organs, thus causing much damage to your body. Some consider lupus along a spectrum, with chronic cutaneous lupus erythematosus (CCLE) on one end, and systemic lupus (which affects your system and organs) on the other.

CLE often manifests at some point if you suffer from systemic lupus erythematosus (SLE), but may also occur without it. Thus, CLE and the resultant skin-related symptoms can be an early indicator of SLE.

Cutaneous lupus erythematosus is classified into three main subtypes:

• Acute cutaneous lupus – The most common indicator of this is a malar rash, which is a rash triggered by sunlight. This may somewhat resembles the wings of a butterfly and can spread across both your cheeks, the bridge of your nose, or your ears.

• Subacute cutaneous lupus erythematosus – This is usually characterized by either coin-shaped red patches on your skin which have a scaly border and a lighter centre, or by red bumps that are scaly which appear in sun-exposed areas.

• Chronic cutaneous lupus erythematosus – The most common form is the classic discoid lupus erythematosus, which is called so because of its coin-like shape. These are usually red and scaly plaques which once resolved can leave behind either light or dark pigmentation marks. These can also cause scarring and atrophy (the thinning of your skin).   

The majority of the people diagnosed with Lupus are women, most often between the ages of twenty and fifty, however children, elderly, and males may also be affected. Patients with CLE exhibit obvious skin lesions frequently in areas that are exposed to the sun. Thus, a relapse of this chronic disease is often induced or worsened by UV light.

If you or someone close has been diagnosed with lupus, or any other autoimmune disease, you can be confident that you will receive quality treatment and advice from the Section of Dermatology at The Aga Khan University and Hospital.  There are many different forms of treatment for the various forms of CLE, depending on your diagnosis. Therefore, it is essential to receive an accurate diagnosis to determine the extent of skin involvement against the systemic involvement (as they may not always directly correlate with each other), and it is important to have regular consultations with your doctor throughout the course of your treatment.

When to seek expert advice

You should visit your doctor and discuss your concerns if you notice any of the symptoms of cutaneous lupus, such as an unexplained rash or increased photosensitivity.

If you have been diagnosed with lupus, you should contact your doctor immediately if you experience any adverse symptoms, such as shortness of breath, blood in your urine or numbness or tingling in your hands or feet.

You should visit the Department of Emergency Medicine immediately if you are experiencing any of the symptoms of a heart attack, such as chest pain or pressure, excessive sweating or shortness of breath.

You should also rush to the Department of Emergency Medicine if you experience any of the symptoms of a stroke, such as sudden numbness, tingling or weakness felt on one side or part of your body (paralysis), a seizure, or sudden nausea or vomiting.