Causes and cutaneous types of lupus

Causes and cutaneous types of lupus

Causes of lupus

There is no single known factor that specifically causes lupus, but rather a combination of factors that trigger symptoms of the condition. Lupus is still, for the most part, a condition undergoing extensive research, especially when it comes to direct causes, and by extension most effective treatments.

The general consensus among researchers and medical professionals is that the following factors in common (or a combination of) have a strong influence on the development of this condition’s symptoms:

  • Genetics: Research indicates that heredity may play a role, but is not necessarily a direct cause of the condition. However, a person can be predisposed if there is a family history. At the same time, it also doesn’t necessarily mean a person is at higher risk (than other people) of developing lupus. 
  • The environment: As with genetics, no definite conclusions through research have been made, but there are commonly noted environmental triggers most cases have in common. These triggers include smoking, stress, toxins, and silica dust. Sunlight (an exposure to ultraviolet / UV light) does trigger a direct internal response in those people more susceptible to the condition. Exposure to sunlight is the only environmental trigger than has been found to be directly associated with skin inflammation and especially, the malar butterfly rash, which are distinct lupus symptoms. Inflammation of internal organs in people more susceptible to developing lupus has also been found to be directly linked to UV light exposure.
  • Hormones: Abnormal oestrogen levels are being researched as a potential risk factor or trigger for lupus. Nothing conclusive has, as yet, been determined as a direct link but numerous studies do suggest that hormonal abnormalities could play a role in disease development.
  • Infections: Many types of viral (and bacterial) infections have been researched and it is strongly believed that these may be linked to triggering lupus symptoms or causing a relapse. Most associations, however, are still being researched to establish direct links. Viruses or infections believed to play a role include cytomegalovirus, hepatitis C, and the Epstein-Barr virus.
  • Medications: Direct links between lupus and the long-term use of medications for other chronic conditions are undergoing extensive research. Drug-induced lupus erythematosus (DILE) is classified as a subset of the condition, but has been found to be rare. Common medications that have been found to play a role include those used to treat high blood pressure and irregular heartbeats, as well as anti-seizure medications and antibiotics. Symptoms influenced by DILE can subside or clear completely once the specific medication is discontinued.

Cutaneous types of lupus

Lupus dermatitis is classified into 4 cutaneous manifestation types (skin manifestation types). These are:

  • Discoid lupus erythematosus (DLE): This type mainly affects skin that is exposed to UV light (sunlight), resulting in skin lesions which often leave scars once healed. Typically, sunlight exposure does not affect vital internal organs. This is a separate diagnostic entity when there is no vital organ involvement.
  • Systemic rash: Photosensitive and slightly raised erythema occurs on the face, ears, neck, chin, back and arms.
  • Subacute cutaneous lupus erythematosis (SCLE): Scaly red patches, similar to psoriasis, appear and are severely photosensitive.
  • Other: Other skin manifestations such as urticaria, or lichen planus occurs.
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