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Skin
problems are very common in people with lupus. Some skin
rashes and sores (also called lesions or ulcers) are very
specific to lupus, while others can occur in other diseases
as well. A sensitivity to and too much exposure to the
ultraviolet (UV) rays of sun and some types of artificial
light are responsible for aggravating some rashes and
lesions. Many types of skin conditions are common in lupus.
Butterfly rash: This rash over the nose and cheeks
can range from a faint blush to a rash that is very severe,
with scaling. It is very sensitive to light and appears
to gets worse when skin is exposed to sun or certain types
of artificial light. The rash may be permanent or may
come and go.
Discoid lesions: These scarring, coin-shaped lesions
are seen on areas of the skin that have been exposed to
UV light. They may also occur on the scalp and produce
a scarring, localized baldness that is permanent.
Subacute cutaneous lesions: These nonscarring,
red, coin-shaped lesions are very sensitive to UV light.
They can appear scaly and can mimic the lesions seen in
psoriasis. They may occur only on the face or cover large
areas of the body.
Mucous membrane lesions: Mouth ulcers are sometimes
seen in lupus patients. Nose and vaginal ulcers may also
occur. These lesions are usually painless.
Hair loss: In addition to losing hair because of
discoid lesions, some lupus patients may develop a temporary,
generalized hair loss followed by the growth of new hair.
Hair loss may also be caused by infection or by use of
corticosteroids or other lupus medications. A severe lupus
flare could result in defective hair growth, causing the
hair to be fragile and break easily.
Vasculitis: This is a condition in which the blood
vessels become inflamed. Very small blood vessels can
break and cause bleeding into the tissues, resulting in
tiny, reddish-purple spots on the skin known as petechiae
(pe-teke-ee-ah). Larger spots are called purpura and may
look like a bruise. Vasculitis can also cause blood clots
to form, skinulcers to develop, and small black areas
to appear around fingers and toenails. These black areas
are a sign of serious tissue damage. If they begin to
develop, see your doctor immediately.
Raynaud s phenomenon: This is a condition in which
the blood vessels of the fingers and toes react in an
extreme way to cold or stress. They suddenly get very
narrow (vasoconstrict). This decreases the blood supply
going through the vessel. As a result, the fingers and
toes become cold and can become pale or bluish. Pain or
tingling can occur when the hands and feet warm up and
circulation returns to normal.
Drug-induced skin changes: Some drugs used to treat
lupus, such as corticosteroids, immunosuppressives, and
antineoplastics, can affect the skin. Your doctor or nurse
will review these side effects with you if one of these
drugs has been prescribed.
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