Facts on File Encyclopedia of Health and Medicine

which lesions can attack internal structures as well
as the skin.

Symptoms and Diagnostic Path
The characteristic appearance of the skin lesions is
a clear diagnostic marker for DLE. Because the
same skin lesions can be an early indication of
SLE, the diagnostic path includes biopsy of repre-
sentative lesions as well as BLOODtests to assess
ANTIBODYstatus. People whose DLE lesions are pri-
marily above the neck usually have isolated DLE.
People who have DLE lesions both above and
below the neck have increased risk for SLE.

Treatment Options and Outlook

The primary treatment approach for DLE is topical
or injected CORTICOSTEROID MEDICATIONS. In the early
stages of the condition, topical corticosteroids
often limit the lesion’s progression. As the condi-
tion becomes established, the lesions may not
respond as well and the dermatologist may inject a
corticosteroid medication directly into the lesion.
Some people experience relief with medications
otherwise prescribed to treat MALARIA, RHEUMATOID
ARTHRITIS, and severe ACNE, as well as medications
that act on theIMMUNE SYSTEMsuch as the corticos-
teroids and immunomodulators. These medica-
tions have potentially serious side effects and
interact with numerous other medications.
Women who are pregnant or who could become
pregnant cannot take many of them, as they cause
damage to the developing fetus.
The use of some of these medications is OFF LABEL
USE—that is, not a use the US Food and Drug
Administration (FDA) has approved though the
DRUG itself has FDA approval for other uses.
It is important for people who have DLE to
discuss with their doctors, and to fully under-stand,
the potential benefits and risks of all treatment
options. Treatment approaches for DLE target
symptoms though do not cure the condition itself.

MEDICATIONS TO TREAT DLE

Anti-Acne (Retinoids)

isotretinoin acitretin

etretinate tazarotene

Antimalarials

hydroxychloroquine chloroquine

Corticosteroids

triamcinolone hydrocortisone

betamethasone diflorasone

flumethasone mometasone

desoximetasone halcinonide

fluocinonide amcinonide

Immunomodulators

Interferon thalidomide

azathioprine mycophenolate

methotrexate dapsone

Risk Factors and Preventive Measures

Researchers do not know for certain what autoim-

mune mechanisms cause the lupus disorders, or

what triggers them. Because DLE and SLE seem to

run in families, a genetic component is likely. At

present there are no known preventive measures.

Though women are more likely than men to

develop DLE, there are no clear risk factors for the

condition other than family history. Early treat-

ment minimizes the residual scarring, atrophy,

alopecia (hair loss), and other permanent conse-

quences the lesions can cause.

Cigarette smoking worsens the lesions, so doc-

tors strongly advise people who have DLE and

smoke to stop. Sun exposure also increases the

frequency and number of lesions; liberal applica-

tion of high-SPF sunscreen and sun-blocking

clothing can mitigate this effect.

See also AUTOIMMUNE DISORDERS; LEUKOPLAKIA;

LESION; LICHEN PLANUS; SARCOIDOSIS; SJÖGREN’S SYN-

DROME; SMOKING CESSATION; SUN PROTECTION.

dry skin See ICHTHYOSIS.

dry skin 153