What Are the Different Discoid Lupus Symptoms?

Discoid lupus erythematosus (DLE) is a chronic recurrent disease. Discoid lupus erythematosus rash is a persistent discoid red patch, mostly round, round or irregular, with a size of several millimeters, or even more than 10 millimeters. The border is clear. The surface of the rash is covered with telangiectasias and gray-brown adhesive scales. The bottom of the scales has horn plug protrusions. The scales can be seen by removing the scales.

Basic Information

Visiting department

Division of Rheumatology

Multiple groups

Women of childbearing age

Common locations

skin

Common causes

Genetics, drugs, infections, immune disorders, etc.

Common symptoms

Erythema, scales, atrophy, erosion, fading or pigmentation on the lips,

Causes of discoid lupus erythematosus

Heredity

The prevalence of this disease varies among different races. Family survey shows that about 10% to 20% of the first- and second-degree relatives of DLE patients may have similar diseases, and some may have hyperglobulinemia, a variety of autoantibodies, and abnormalities of T suppressor cells. The coincidence rate was 24% to 57%, while that of dizygotic twins was 3% to 9%.

2. Drugs

Drug-induced diseases can be divided into two categories. The first category is drugs that induce DLE symptoms, such as Baotaisong and gold preparations. The second category is drugs that cause lupus-like syndromes, such as hydrazine hydrochloride (hydrazine), procainamide, chlorpromazine, phenytoin sodium, and isoniazid.

3. infection

Some people think that its incidence is related to the infection of certain viruses (especially lentivirus). Inclusion substance-like substances can be found in patients' glomerular endothelial cell plasma, vascular endothelial cells, and skin lesions. At the same time, the patient's serum increased the virus titer, especially against measles virus, parainfluenza virus type , , EB virus, rubella virus and myxovirus.

4. Physical factors

Ultraviolet rays can induce skin lesions or exacerbate the original skin lesions. A few cases can induce or exacerbate systemic lesions. Two months later, the skin fluorescence band test is positive. For example, Aping can prevent skin lesions. Some people also think that ultraviolet rays first cause skin cells to be damaged, and anti-nuclear factors can enter the cells and interact with the nucleus to cause skin damage. Cold and strong electro-optical irradiation can also induce or aggravate the disease. Some localized discoid lupus erythematosus can develop into a systemic type from chronic to acute type after exposure.

5. Endocrine factors

In view of the fact that there are significantly more women than men in this disease, and most of them occur during fertility, it is believed that estrogen is related to the occurrence of this disease. In addition, oral contraceptives can induce lupus-like syndrome.

6. Immune abnormalities

The immune function of a person with DLE genetic qualities is affected by the above-mentioned causes. When genetic factors are strong, weak external stimuli can cause disease. Conversely, when genetic factors are weak, their pathogenesis requires strong external stimuli.

Clinical manifestations of discoid lupus erythematosus

At the beginning of the disease, the active lesion was erythematous round scaly papules with a diameter of 5-10 mm and accompanied by hair follicle embolism. Skin lesions are common in the raised parts of the cheeks, the bridge of the nose, the scalp, and the external auditory meatus, and can persist or repeat for years. Skin lesions can spread to the upper trunk and extensor limbs. Photosensitivity is more common, manifested as sheet-like damage to the skin by light. Mucosal involvement can be very prominent, especially oral ulcers. The untreated DLE lesions gradually expanded outward, and the central area of the lesions atrophied. Residual scars do not shrink. Peel off the scales forcefully, and you can see thorn-like protrusions on the scales, which are tied in the mouth of the expanded hair follicle, and are called "carpet pushpins". Extensive hair loss on the head and permanent scarring.

Although the disease is usually confined to the skin, nearly 10% of patients eventually develop systemic manifestations of varying degrees, which are generally not severe and may only be positive for antinuclear antibodies. Decreased white blood cell count and mild temporary systemic manifestations such as joint pain. Only a few patients with DLE develop chronic bursitis.

Discoid lupus erythematosus examination

Laboratory inspection

Serum immunological examination: antinuclear antibodies can be positive, rheumatoid factor can be positive, immunoglobulins (IgG, IgA, IgM) can be increased at the same time, anti-ENA antibodies can be positive.

2. tissue biopsy

Tissue biopsy is of great significance for diagnosis.

3. Lupus Band Test (LBT)

It is helpful for the diagnosis and differentiation of LE.

Discoid lupus erythematosus diagnosis

1. There are erythema, scales, atrophy, erosion, fading or pigmentation on the lips, and the lesions extend to the skin.

2. There are erythema, erosion, and atrophy in the mucous membrane in the mouth, and there are white short lines arranged radially.

3. Butterfly-shaped erythema, scales, horny plugs, hypopigmentation or atrophy on the cheeks.

Discoid Lupus Erythematosus Treatment

Should be treated early to prevent permanent atrophy. You must minimize exposure to sunlight or UV rays, and use UV protection when you go out.

Local drug therapy

topical corticosteroids; topical tacrolimus; liquid nitrogen or dry ice cryotherapy.

2. Oral medication

Antimalarial drugs such as chloroquine, etc., chloroquine has anti-light and stable lysosomal membranes, anti-platelet aggregation and adhesion, and decreases after the condition is improved;