Cutaneous Lupus Erythematosus (CLE)

Cutaneous Lupus Erythematosus is a chronic autoimmune disease and one form of lupus.

This form of lupus is limited to the skin. Approximately two-thirds of people with lupus will develop some form of CLE. Skin disease in lupus can cause rashes or sores (lesions), most of which will appear on sun-exposed areas such as the face, ears, neck, arms, and legs.

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Approximately two-thirds of people with lupus will develop some form of CLE
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Cutaneous lupus occurs in three forms:

  • Chronic Cutaneous Lupus (CCLE)
  • Subacute Cutaneous Lupus (SCLE)
  • Acute Cutaneous Lupus (ACLE)

Chronic Cutaneous Lupus (CCLE)/Discoid Lupus (DLE)

The most common form of CCLE is Discoid Lupus (DLE), which appears as disk-shaped, round lesions that are raised, scaly, and red. Usually they do not itch or hurt. The sores usually appear on the scalp and face but sometimes they will occur on other parts of the body as well. These lesions can produce scarring and skin discoloration (darker and/or lighter colored areas). Discoid lesions that occur on the scalp may cause hair to fall out. If the lesions form scars when they heal, hair loss may be permanent.

Discoid Lupus lesions can be very sensitive to light (photosensitive), so it’s important to avoid being outside during peak sunlight hours and make sure you wear sunscreen and protective clothing if you are out in the sun.

Discoid Lupus normally occurs without Systemic Lupus (SLE). However, some patients with SLE do get discoid lesions, and about 5% of those with localized DLE (above the neck) and 20% of those with generalized DLE (above and below the neck) can get systemic symptoms.  Patients with DLE should be evaluated regularly to make sure that SLE is not developing.

Subacute Cutaneous Lupus (SCLE)

Subacute Cutaneous Lupus lesions may appear as areas of red scaly skin with distinct edges or as red, ring-shaped lesions, most commonly on sun-exposed areas of the arms, shoulders, neck, and body. They usually do not itch or scar, but they can leave the skin discolored. Lesions are also sensitive to light, so preventive measures should be taken when spending time outdoors or under fluorescent lights. SCLE is not often associated with SLE, but it is always important to keep your doctor informed of new symptoms or changes.

Acute Cutaneous Lupus (ACLE)

Acute Cutaneous Lupus lesions occur when your SLE is active. The most typical form of acute cutaneous lupus is flat red patches on the face that resemble a sunburn. When the rash appears on both cheeks and across the bridge of the nose in the shape of a butterfly, it is known as the “butterfly rash.” The rash can also appear on arms, legs, and body. These lesions tend to be very sensitive to light. The lesions are non-scarring but change in skin color can occur.

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