The classic lupus rash is a redness on the cheeks (malar blush) often brought on by sun exposure. But, we SLE sufferers can get many different rashes for many different reasons. Discoid lupus with the red skin patches on the skin and scaliness is a special characteristic rash that can lead to scarring. It usually occurs on the face and scalp and can lead to loss of scalp hair (alopecia). It is more common in African Americans with lupus. Occasionally, discoid lupus can occur as an isolated skin condition without systemic disease. Hair loss can occur with flares of SLE even without skin rashes in the scalp. In this situation, the hair regrows after the flare is treated. Hair loss can also occur with immunosuppressive medications.
Here is some information on the different types of rashes that we can get:
Lupus Rash - Acute Cutaneous Lupus Erythematosus
Acute Cutaneous Lupus Erythematosus usually presents as an erythematous rash in a butterfly distribution on the face. This blush is slightly edematous and is located in both cheeks and across the bridge of the nose. The lesion usually appears after sun exposure but persists a few days to weeks before healing without scarring. It may be accompanied by erythematous lesions in other areas of the body. Usually more than 90% of the cases have positive ANA, as well as immunoglobulin deposits along the dermoepidermal junction by immunioflourescence studies of the involved skin.Lupus Rash - Subacute Cutaneous Lupus Erythematosus
Subacute Cutaneous Lupus Erythematosus lesions may be localized or generalized. The maculopapular rash usually occur after sun exposure, the lesions are usually pruritic. It may involve any place on the body, and because the erythematosus lesions may involve palms and soles they resemble a drug reaction. The great majority of these lesions heal without scarring, however, persistent lesions that become crusty may heal with only slight atrophy of the skin. This type of rash is associated with a high prevalence (70%) of Ro(SS-A) antibodies; however, only 50% of cases have positive immunoglobulin deposition in lesional skin by immunofluorescence.
Lupus Rash - Chronic Cutaneous Lupus Erythematosus
Chronic Cutaneous Lupus Erythematosus, referred as Discoid Lupus Erythematosus, usually involves the fact, scalp and ears, but it may occur anywhere. The rash may be pruritic. The lesions at the beginning are erythematous, slightly elevated papules or plaques, that in time become raised, bright red, edematous, later on the center becomes depressed, the colour fades and becomes atrophic, while the edematous red periphery slowly enlarges and becomes irregular with some telangiectasias. In older lesions follicular plugging characterized by small round areas of hyperkeratosis are noted. Later on the lesions heal with scar leaving a white area with or without focal hyperpigmentation. These lesions usually heal with scarring and hyperpigmentation or hypopigmentation. In the lesion involving the scalp where the lesions are erythematous and scaly, the hair usually grows back, but if the lesion heals with scarring the alopecia in that area is permanent. The names of the different variants reflect the predominant component of the lesion; the tuidus for example refers to raised lesions that are peculiarly soft to the touch, as the feeling to the touch obtained compressing a cotton hall. Only 5-10% of cases have a positive ANA, and immunoglobulin deposits at the dermoepidermal junction are present in 80% of involved skin by immunofluorescence studies, but usually immunofluorescence studies are negative in lesions less than three months old.
Lupus Rash - Lupus Panniculitis
Lupus Panniculitis, appears as deep nodules. The lesion is situated below the skin in the subcutaneous tissue, and heals with a deep atrophy of the involved area.
Lupus Rash - Bullous Lupus Erythematosus
Bullous Lupus Erythematosus is characterized by the presence of blisters which contain a clear seurous fluid, and may range from 3 to 40mm in diameter. The rash usually appears in sun exposed areas, and only rarely is associated with burning sensation, mild pruritus or redness. Some papules may accompany the blisters. The lesion may resolve spontaneously usually without a scar after a week, but they reappear episodically.
I hope that this information has been helpful :lol:
Best of Luck