The Three Types of Lupus
When you think of lupus, you're probably thinking of the most common type called Systemic Lupus Erythematosus (SLE). SLE also tends to be the most serious form of lupus. However there are two other types of this autoimmune disease, called Discoid Lupus Erythematosus (DLE) and Drug-Induced Lupus.
Before we differentiate between the three types of lupus, let's talk about how this disease works in general. The symptoms of all lupus types result from the same thing; auto-antibodies. Normally, your immune system creates antibodies which attach to foreign objects, aiding in their identification and subsequent destruction. When antibodies attach to particles or cells within the body, they're known as auto antibodies. When these auto-antibodies stick to small proteins they create clumps called immune complexes which can get stuck in tiny capillaries. While larger blood vessels run all over the body, the tiny capillaries make up the bulk of the circulatory system, allowing oxygen to diffuse throughout the body. As immune complexes get stuck in these capillaries they become inflamed, resulting in rashes and, in severe cases, loss of tissue function.
Systemic Lupus Erythematosus
SLE is estimated to affect between 200,000 and 1 million Americans, the large majority of which are women. In milder cases it affects only the skin and joints, causing inflammation and rashes. However, it is capable of causing damage to almost any organ or system including the kidneys, heart, lungs, circulatory system and nervous system. Symptoms of SLE come and go in periods of remission and activity. Certain things like sunlight or stress can trigger lupus symptoms to appear suddenly, called a flare. Most people with SLE keep their flares under control with diligent treatment and self-care.
Discoid Lupus Erythematosus
DLE, or Cutaneous lupus, generally only affects the skin. It is diagnosed by the disc-shaped rashes present on the face, scalp, neck, or arms. The rash is usually 5 to 10 mm in diameter, raised, with a darker red ring surrounding a scaly pink inner circle. Those with DLE are usually very sun-sensitive and must be careful to avoid ultraviolet light with clothing and sunscreen. About 10% of DLE cases progress into the more serious SLE. DLE occurs more commonly in women (by about 3 to 1) and generally develops around age 30. However, men and women can develop the disease at any age. Treatment of DLE involves the use of creams and ointments to reduce skin inflammation.
This last form of lupus affects men and women of all ages and races pretty much equally. Drug-induced lupus is a short-lived form of the disease which occurs in response to taking a certain drug. The symptoms of this type usually resolve within several days of stopping the offending medication. Strangely, the symptoms of drug-induced lupus usually appear after taking a drug for several months or years. Its most common symptoms are inflammation of the joints, flu-like symptoms, skin rash, and serositis (inflammation around the heart and lungs). Drug-induced lupus has been linked to those who metabolize drugs slower than normal. Treatment usually just consists of stopping the drug and reducing inflammation. For more detailed information on the three types of lupus check out our three part series.