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kelibeli
04-02-2006, 10:40 AM
I am hoping somebody has some insight on this. I keep forgetting to ask my rheumatologist about it:

I have SLE and for the past 5 or 6 months I have been getting skin lesions on my upper arms. They are mostly flat to my skin and roundish, and between the size of a dime and nickel. They get scaly and dry and then flake off after about a week. Then I am left with a bleached out scar in its place.

These are only affecting the area between my shoulder and my elbow, a part of my body that has not seen the sun since these started. I wouldn't be so concerned except that they seem to be permanently bleaching my skin even whiter than it already is.

I am photosensitive but like I said my upper arms are always covered. So I don't get it. Has anybody else had similar problems? If so, is there anything I can do to help with the scars?

Thanks,
Kelli

Saysusie
04-04-2006, 08:42 AM
Hi Kelibeli:
People with lupus can develop many different types of skin lesions. Lupus patients can suffer from Chronic Cutaneous LE (CCLE) of which Discoid lupus (DLE) is the most common form of CCLE. The coin-shaped or disk-like “discoid,” lesions are mostly present on the scalp and face, but can be seen on other parts of the body. Patients with discoid lesions limited to the head, ears, and neck are classified as “localized DLE.” Patients with DLE discoid lesions on other body locations are classified as “generalized DLE;” some of these patients may rarely progress to SLE. DLE lesions are red, scaly, and thickened. With time, there can be scarring, atrophy (thinning), and discoloration of skin (darkly colored and/or lightly colored areas). When discoid lesions occur on the scalp, permanent hair loss (alopecia) can result. DLE lesions are usually painless and do not itch. Sun exposure may make lesions in CCLE patients worse. Skin cancer can occasionally develop in long-standing DLE lesions. Any changes should be brought to your dermatologist's attention.
The term "skin lesion" refers to a distinct area of abnormal skin. Lupus skin disease can be divided into two broad categories:
1. Skin lesions that are seen only in people with LE. These three types of lesions are:
chronic cutaneous LE (CCLE), also called discoid LE (DLE)
subacute cutaneous LE (SCLE)
acute cutaneous LE (ACLE).
2. Skin lesions that can occur in people with LE but can also occur in other diseases. There are a number of forms of skin disease in this category, such as:
vasculitis
calcinosis (calcium deposits in the skin)
hair loss (alopecia)
rheumatoid nodules
Raynaud's phenomenon
livedo reticularis.
There are two specific lesions associated with lupus erythematosus: discoid lesions (characteristic of discoid lupus erythematosus), and coin-shaped, non-scarring lesions (characteristic of subacute cutaneous lupus erythematosus).
The scarring coin-shaped lupus lesion commonly seen on areas of the skin that are exposed to light has been termed discoid lupus erythematosus. he second type of specific lupus lesion is characterized as a non-scarring, erythematosus (red), coin-shaped lesion which is very photosensitive (gets worse when exposed to UV light) but can occur on skin that it not normally exposed to UV light. The subacute cutaneous lupus lesions can sometimes mimic the lesions of psoriasis or they can appear as non-scarring, coin-shaped lesions. These lesions can occur on the face in a butterfly distribution, or can cover large areas of the body. Unlike the discoid lupus lesions, these lesions do not produce permanent scarring.
Systemic lupus erythematosus patients may also develop inflammatory disease of the blood vessels (vasculitis). The cutaneous manifestations of vasculitis are varied. The lesions may appear as red welts involving large areas of the body. These lesions can also present as small red lines in the cuticle nail fold or on the tips of the fingers or as red bumps on the legs. In addition, these red bumps may ulcerate. At times, the blood vessels that are involved in this inflammatory process may be deep in the skin producing painful, red nodules.
I hope that this has been helpful to you

Peace and Blessings
Saysusie

kelibeli
04-04-2006, 11:39 AM
Thank you Saysusie. This is helpful. I guess I didn't realize a person could have both DLE and SLE.
-Kelli