Cutaneous lupus erythematosus is a type of lupus in which the immune system attacks the skin. The main trigger of cutaneous lupus or skin lupus is exposure to ultraviolet (UV) rays through sunlight (UVA and UVB) or artificial light. Other triggers include:
- Exposure to silica dust in agricultural or industrial settingsAbnormalities in genes related to the immune system
- Certain medications including:
- Over-the-counter drugs for acid reflux
- Sulfa drugs such as Bactrim and Septra
- Sun-sensitizing tetracycline drugs such as minocycline
- Penicillin or other antibiotic drugs such as amoxicillin, ampicillin and cloxacillin
- Physical stress to the body such as (surgery, injury, pregnancy)
- Emotional stress (divorce, illness, death in the family)
- Viral infections or illnesses
What causes cutaneous lupus?
Although it is still unclear exactly what causes cutaneous lupus, experts believe that it is the result of a complex interplay of multiple factors that cause systemic lupus. Those factors may include:
- Sunlight exposure:
- Ultraviolet (UV) radiation promotes cell death, causing skin manifestations in patients with cutaneous lupus. These dead cells, in turn, become targets for autoantibodies.
- Antibodies are normally produced by the immune system to identify and attack foreign proteins in the body, which could be due to an infection.
- Autoantibodies are abnormal antibodies that attack healthy tissues and cause inflammation and damage to the body.
- In addition, UV radiation promotes the release of mediators called cytokines, which can ultimately activate and recruit inflammatory cells.
- The genetic make-up of a person likely predisposes them to cutaneous lupus. Various genes that play a role in the recognition of foreign proteins (major histocompatibility complex genes) have been identified to contribute to the development of cutaneous lupus.
- Certain ethnic groups (people of African, Asian, Hispanic/Latino, Native American, Native Hawaiian, or Pacific Island descent) have a high risk of lupus, which may be related to genes they have in common.
- Environmental factors:
- Medications, chemical exposure, and viruses randomly encountered by a genetically susceptible individual may work to trigger the disease.
- Hormonal factors:
- The female hormone estrogen is speculated to play a role in the development of the disease, and symptoms flare up during periods of higher estrogen levels such as during the menstrual cycle or pregnancy.
What are the symptoms of cutaneous lupus?
Symptoms of skin lupus can range from mild to severe and may flare up at certain times if exposed to triggering factors. Characteristics of cutaneous lupus include the following:
- Red, scaly areas that may be round (resembling a coin or a disk) with darker red rings or borders outlining the scaly patches
- Rash can appear anywhere on the body but more commonly develop in areas that have had sun exposure
- Rash that extends across the cheeks and over the bridge of the nose (butterfly rash)
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Cutaneous Lupus (Skin Lupus). Cleveland Clinic: https://my.clevelandclinic.org/health/diseases/21601-cutaneous-lupus-skin-lupus
Cutaneous Lupus Symptoms and Treatments. Arthritis Foundation: https://www.arthritis.org/diseases/more-about/cutaneous-lupus-symptoms-and-treatments
What causes lupus? Lupus Foundation of America: https://www.lupus.org/resources/what-causes-lupus
Trigger factors of cutaneous lupus erythematosus: a review of current literature. NIH: https://pubmed.ncbi.nlm.nih.gov/28173739/
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