INTRODUCTION: DLE, also sometimes called chronic cutaneous lupus erythematosus, is a set of skin changes that can occur as part of lupus, with or without systemic involvement.
DISCOID LUPUS ERYTHEMATOSUS (DLE)
INTRODUCTION: DLE, also sometimes called chronic cutaneous lupus erythematosus, is a set of skin changes that can occur as part of lupus, with or without systemic involvement.
THE DISEASE PROGESS: - Skin lesions begin as erythematous plaques and progress to atrophic scars. They cluster in light-exposed areas of the skin, such as the face, scalp, and ears. Untreated, lesions extend and develop central atrophy and scarring. There may be widespread scarring alopecia. Mucous membrane involvement may be prominent, especially in the mouth. Sometimes lesions are hypertrophic and may mimic lichen planus (called hypertrophic or verrucous lupus).
- People with DLE get round sores, usually on their face and scalp.
- Another name for the disease is Chronic cutaneous lupus.
SYMPTOMS: - People with lupus often have chest pain, fatigue, fever, joint pain or swelling, photosensitivity (sensitivity to light).
DLE is a chronic dermatological disease that can lead to scarring, hair loss and hyperpigmentation changes in skin if it is not treated early and promptly. It has a prolonged course and can have a considerable effect on quality of life. Early diagnosis and treatment improves the prognosis.
DIAGNOSIS: -
Patients presenting with typical discoid lesions should be evaluated for systemic lupus erythematosus (SLE). Antibodies against dsDNA are almost invariably absent in DLE. Although it does not differentiate DLE from SLE, biopsy can rule out other disorders (eg, lymphoma or sarcoidosis). Biopsy should be done from the active margin of a skin lesion.
Early treatment of DLE can prevent permanent atrophy. Exposure to sunlight or ultraviolet light should be minimized (e.g., using potent sunscreens when outdoors).
Topical corticosteroid ointments (particularly for dry skin) or creams (less greasy than ointments) 3 to 4 times a day (e.g., triamcinolone) usually cause involution of small lesions; they should not be used excessively or on the face (where they cause skin atrophy). Resistant lesions can be covered with plastic tape coated with flurandrenolide).
HOMOEOPATHIC MEDICINES FOR MANAGING DLE
1) BELLADONNA: - typically suited in mallar rash or butterfly rash with neuro-psychiatric symptoms where C.N.S involvement is markedly noted.
2) MERCURIOUS SOLUBILIS: - whenever in case of lupus there are oral and/or nasopharyngeal ulceration this remedy is very well suited.
3) BORAX: - again this is best suited in mucosal ulceration are more marked in oral mucosa than in nasopharynx.
4) SYPHILLINUM: - a nosode, a dose can be given intercurrent as anti-miasmatic of the cases that shows syphilitic miasma in the background. Also useful in cases showing painless red mallar rash. Erythematosus, also suited well in ulcerations of oral and nasopharyngeal mucosa.
5) CINCHONA OFFICINALIS: - In cases with signs of haemolytic anaemia.
6) FERRUM PHOSPHORICUM: - Where the patient has febrile condition due to disease with malaise, fatigue, hair loss and anaemia.
