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Why Sunlight Affects the Skin of People with Lupus

By HERWriter
 
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Lupus related image Photo: Getty Images

People who have lupus tend to have an extra sensitivity to the sun called photosensitivity. There are a few different types of lupus, which is considered to be an autoimmune disease. Systemic lupus affects the entire body but cutaneous lupus predominately affects just the skin. Cutaneous lupus is further divided into two groups: discoid lupus erythematosus (DLE) and subacute cutaneous lupus erythematosus (SCLE). The actual cause of lupus is not known but researchers do think they understand why people with lupus react so strongly to sun exposure.

It is common for people with lupus to develop rashes after exposure to the sun. A butterfly rash which appears on the face across the nose and cheeks is the classic lupus rash. People with DLE may develop a “disk-like” rash on sun-exposed skin or those with SCLE may develop a red circular rash on their chest, back and arms that is scaly and raised.

“Patients with lupus are most sensitive to UVA and UVB light,” said Amita Bishnoi, MD, a rheumatologist at Henry Ford Hospital in Detroit. (1)

Why sunlight causes lupus photosensitivity:

According to Dr. Thomas Millard, Research Registrar in Dermatology at St. Thomas Hospital in London, UV light stimulates a type of allergic response on the surface of the skin. Protein antigens, two of which are called “Ro” and “La” react with antibodies such as, “anti-Ro” and “anti-La” which attach themselves to the proteins. White blood cells are then attracted to the skin and attack the skin cells causing a rash to develop. (2)

In addition, research has shown that certain skin cells in lupus patients die off and excessively accumulate. This over-accumulation of dead skin cells contributes to the inflammatory process increasing the rash. “Another recent study found too much nitric oxide may be made in the skin of lupus patients after sun exposure, which may lead to redness and inflammation. It is unknown why any of these mechanisms are more active in patients with lupus.” (2)

Recent research by Vicki Rubin Kelley M.D. has added further knowledge as to why sunlight’s UV rays can trigger cutaneous as well as systemic lupus in some people. Kelley and her colleagues have found through experiments with mice that a damaging substance called Colony Stimulating Factor 1 (CSF-1) is produced when susceptible people’s skin are exposed to the sun. CSF-1 “then recruits and modifies white blood cells, which in turn stimulates the most common form of skin lupus (DLE) in genetically susceptible individuals.” (3) Her desire in future research is to explore ways to block CSF-1 using a topical skin lotion.

Prevention:

It is most important for those suffering from lupus to make sure they have adequate protection from the sun. Use of sunscreen with an SPF above 15, wearing sun protective clothing and following general guidelines to avoid sun during the most intense UV ray radiation times of the mid-day are crucial to avoid stimulating lupus related rashes.

Sources :
1. Sun exposure and Lupus
www.everydayhealth.com/lupus/sun-exposure-and-lupus.aspx

2. Sunlight and Lupus
http://www.lupus-support.org.uk/Sun.htm

3. Discovery: How Sunlight Triggers Lupus
http://www.lupusresearchinstitute.org/discoveries/090128/kelley

Sunlight triggers cutaneous lupus through a CSF-1-dependent mechanism in MRL-Fas(lpr) mice. www.ncbi.nlm.nih.gov/pubmed/18981160?dopt=Abstract

Edited by Alison Stanton

Michele is an R.N. freelance writer with a special interest in woman’s health care and quality of care issues. Other articles by Michele are at www.helium.com/users/487540/show_articles

Add a Comment6 Comments

EmpowHER Guest
Anonymous

my face has had the brownish butterfly rash for 4 years now. is there anything i can do to GET IT OFF OF MY FACE .. of all places right? :(;(

November 9, 2011 - 9:52pm
EmpowHER Guest
Anonymous

I have RA and I just went to the Dr and he told me that my recent lab work showed positive to Lupus. I have recently felt discomfort all over. Almost like my top layer of skin aches. A cold sensation that I can't seem to explain. If anyone has had this similar reaction and is link to Lupus pls let me know.

Thanks

September 9, 2011 - 11:45am
EmpowHER Guest
Anonymous

Skin Lupus and the Sun

Hi all, my name is Suzanne and I’ve noticed that many people here are talking about skin lupus and the effects of the sun. Through some research, I found this website and thought you might find the tips there useful. I’ve been researching skin lupus and the difficulties the disease can bring because I work with a company that is dedicated to connecting people to clinical research studies. If you would consider a clinical research study, visit our website to learn more: www.lupusskin.com/sns.htm

August 2, 2011 - 8:25am
HERWriter

Hi Anon,

I am sorry about the pain you obviously are in with the multiple autoimmune diseases you have. I hear your frustration. I did a quick search and it looks like they are trying to research new drugs with limited success.
http://www.lupusresearch.org/research/acr/latest_advances.html

It sounds like you may need other options to manage your pain and I would encourage you to look into both mainstream and alternative options, which there are many, to see what might help. I don't know if topical pain meds might be of benefit but that might be another option to look into.
take care, Michele

July 7, 2011 - 9:58am
EmpowHER Guest
Anonymous (reply to Michele Blacksberg RN)

Yes Iam very frustrated, as I imagine we all are. The pain is in my bones, muscles, nerves, skin, joints and organs. I have tried everything and Im not a canidate for any injections just the methatrexate and steroids. No one wants to take pain meds, no one wants pain, it is what it is however. I just dont understand with our numbers higher than any cancer that we cant do better or have a better quality of the short life we are given. Thank you for you time and interest in womens health.

July 7, 2011 - 10:16am
EmpowHER Guest
Anonymous

This is an informative article on the rashes caused by lupus, but doctors are still so far behind on auto immune diseases that run higher in women than men. I have SLE, RA, sjogren's and fibro and get the rash on my face, neck, shoulders and back. What have they found to help or prevent? Nothing. Sunscreen does not keep me from getting rashes regardless and avoiding the sun altogether is impossible. What have they come up with to help? I have been poked, prodded and scanned to exhaustion and so have alomost all the female members of my family. I do beleive it is genetic, Im living proof that it is and yet the medicines I take do not help. The painkillers do not take away the pain and the doctors have come no further. So knowing we wear the sun screen, avoid the sun and still get rashes and our bodies break down along with our immune systems, what has been invented to help us????

July 7, 2011 - 9:24am
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We value and respect our HERWriters' experiences, but everyone is different. Many of our writers are speaking from personal experience, and what's worked for them may not work for you. Their articles are not a substitute for medical advice, although we hope you can gain knowledge from their insight.

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