Lupus

Discoid lupus must be just like “regular” lupus, right? I mean, lupus is lupus, no? You’d think so, but like most things within Rheumatology, it rarely makes that much sense. When one speaks of “lupus” they are usually talking about SLE or Systemic Lupus Erythematosus. SLE is a systemic (affects the entire body), autoimmune condition. Discoid Lupus, or DLE, is a condition solely of the skin. One can certainly have “discoid lesions” when they have SLE and we are always on alert for the development of SLE, but rest assured, they are two different entities. 

The name “discoid” stems from the description of the typical rash seen with DLE: a disc shaped, red patch with a scale and with scaring. It is common to worry about “progression to SLE.” Thankfully, development of SLE is the exception, rather than the rule. Although dermatologists are often the main caregivers of DLE, a full evaluation by a rheumatologist can provide insight and peace of mind.

I’ve sat down with hundreds of young women as they find out they have lupus. Once a diagnosis is made, the conversations are largely one-sided. Explaining what lupus is, how we diagnosis it, and what we are going to do about it can take a while. I’ve seen every possible emotion you can think of wash over the faces of women as they absorb this news: relief at an answer, sadness at what it means, anger at why them, and then fear for their future. The fear, for many, circles around concerns over the possibility of a pregnancy with lupus. 

Lupus can affect anyone, but young women are the most commonly affected. Women in their teens, twenties and thirties, or what we call in medicine, the child-bearing years. Discussing issues related to pregnancy is a necessary component to a well-rounded lupus treatment strategy.