Systemic Lupus Erythematosus:  A chronic inflammatory disorder of the connective tissue, it affects multiple organ systems , as well as the skin and can be fatal.  It's characterized by recurring remissions and exacerbation.  Exacerbation's are especially common during the spring and summer.  Early detection and treatment is essential and prognosis improves, but patients may develop cardiovascular, renal or neurologic complications or severe bacterial infections.  This disorder strikes women more than men.

Cause:  Studies shows that it is interrelated immunologic, environmental, hormonal, and genetic factors as  possible causes.  Risk factors may be due to viral infections, exposure to sunlight or ultraviolet light, immunization, pregnancy,  abnormal estrogen metabolism., stress, streptococcal or viral infections, and may include genetic predisposition.

Symptoms:

Facial erythema (butterfly rash)
Photosensitivity
Nonerosive arthritis
Discord rash
Oral or nasopharyngeal ulceration
Pleuritis
Pericarditis
Seizures
Psychoses
Patchy alopecia
Aching
Malaise
Fatigue
Low grade fever
Chills
Anorexia
Weight loss
Lymp node enlargement
Abdominal pain
Nausea and or Vomiting
Diarrhea or constipation
Irregular menstrual periods

Treatment:

For mild symptoms:  Nonsteroidal anti-inflammatory drugs,  Topical treatment for skin lesions.

Refractory skin lesions are treated with intralesional corticosteroids or antimalarials, such as hydroxychloroquine and chloroquine..  These type of medications can cause retinal damage, such treatment requires ophthalmologic examination every 6 months.

Corticosteroids.

 

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Discoid Lupus Erythematosus:  is a form of lupus erythematosus marked by chronic skin eruptions that, if untreated, can lead to scarring and permanent disfigurement.  About 1 out of 20 patients with discoid lupus erythematosus later develops systemic lupus erythematosus. 

Cause:  The exact cause is unknown, evidence suggest an autoimmune defect.

Symptoms:

Lesions are red, raised, scaling plaques, with follicular plugging and central atrophy.  The raised edges and sunken centers give them a coin like appearance.  Lesions can appear anywhere on the body, they usually erupt on the face, scalp, ears, neck, and arms or on any part of the body that's exposed to sunlight..
Hair may become brittle or may fall out in patches.

Treatment:

Tropical intralesional, or systemic medication
Avoid prolonged exposure to sun, fluorescent lighting, or reflected sunlight.