Discoid Lupus Erythematosus (DLE)/ Lupus Erythematosus Chronicus Discoides.

Discoid lupus erythematosus is an autoimmune disease that targets the skin which occurs in genetically predisposed people.  It is a disease that affects the skin especially that of face with characteristics of wasting and scarring and marked photosensitivity. The condition occurs in the form of rash or lesions on the face and hands. The rash usually aggravates with exposure to sunlight. Hair loss and changes in skin color are also witnessed.

discoid lupus erythematosus

 

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The skin lesions of discoid lupus erythematosus are round, slightly raised from the surface. The lesions are initially reddish and are covered by scales. Scales get thickened with changes in color. The centre of the lesion is light colored where as borders of the scales are darker, as the lesions grow they merge with each other. The result of these skin lesions is in wasting and scarring of the skin.
Age / Sex prevalance of Discoid Lupus Erythematosus (DLE)/ Lupus Erythematosus Chronicus Discoides.

Most common in women between ages of 17 to 40 years. Women are more affected than men.

Race affected by Discoid Lupus Erythematosus (DLE)/ Lupus Erythematosus Chronicus Discoides.

It is more common in African Americans than Asians or Caucasians.

Classification of Discoid Lupus Erythematosus (DLE)/ Lupus Erythematosus Chronicus Discoides.

• Localized discoid lupus erythematosus:  In localized discoid lupus erythematosus, the head and neck are involves and is treated if given proper timely treatment.
• Widespread discoid lupus erythematosus: In this other parts of body are also affected. Person with widespread discoid lupus may have chances to develop systemic lupus erythematosus and it is difficult to treat.
• Hypertrophic discoid lupus erythematosus: The lesions are wart like mainly on back of arms. This type is very difficult to treat.

Causes of Discoid Lupus Erythematosus (DLE)/ Lupus Erythematosus Chronicus Discoides.

• Family history.
• Cigarette smoking.
• Any alters in DNA in the skin.
• Environmental factors like sun or virus.
• Immune complex formation.
• Stress.

Discoid Lupus Erythematosus (DLE)/ Lupus Erythematosus Chronicus Discoides Signs and Symptoms

• Skin discoloration or scars.
• Rapid breathing.
• Irregular heartbeats.
• Blue or pale lips.
• Inability to urinate.
• Fast heart rate.
• Painless mouth ulcers
• Joint pains with swelling
• Chest pain
• Headache
• Tiredness
• Anaemia
• Convulsions
• High blood pressure
• Fatigue
• Weakness
• Weight loss
• Skin rash, butterfly rash over nose and cheeks
• Brittle hair or hair loss
• Red sore dry eyes
• Nausea, vomiting with abdominal pain
• Photosensitivity
• Headache, migraine, seizures, stroke
• Muscle pain and stiffness.
• Sleep disorders
• Thought and concentration disturbance
• Raynaud’s phenomenon
• Sun sensitivity
• Itchy and small swelling on the skin.

Investigations of Discoid Lupus Erythematosus (DLE)/ Lupus Erythematosus Chronicus Discoides.

• Complete case history.
• Complete blood count.
• Renal/liver function test.
• Erythrocyte sedimentation rate (ESR).
• Antinuclear antibody test (ANA).
• Anti-dsDNA.
• Biopsy.
• Syphilis test.
• Urinanalysis.
• Rheumatoid factor.
• Echocardiogram.
• Other antibody tests.

Treatment of Discoid Lupus Erythematosus (DLE)/ Lupus Erythematosus Chronicus Discoides.

• Anti-inflammatory drugs
• Non steroidal inflammatory drugs (NSAIDs)
• Anti malaria drugs
• Corticosteroids
• Immune suppressing drugs
• Cytotoxic
• Gamma globulins
• Physiotherapy as an alternate treatment.
• Psychiatric counseling.

Prognosis of Discoid Lupus Erythematosus (DLE)/ Lupus Erythematosus Chronicus Discoides.

Prognosis is good if early treatment is done it may reduce scarring or atrophy. Pain in lesions may continue and disfiguration from scars and atrophy will be permanent.

Complications of Discoid Lupus Erythematosus (DLE)/ Lupus Erythematosus Chronicus Discoides.

• Systemic lupus erythematosus (SLE)
• Malignant degeneration ( basal cell carcinoma or squamous cell carcinoma (SCC))
• Depigmentation.

Differential diagnosis of Discoid Lupus Erythematosus (DLE)/ Lupus Erythematosus Chronicus Discoides.

• Systemic lupus erythematosus (SLE)
• Plaque psoriasis
• Actinic keratosis
• Warts
• Sracoidosis
• Syphilis
• Dermatomyositis
• Lichen planus

Diet / management of Discoid Lupus Erythematosus (DLE)/ Lupus Erythematosus Chronicus Discoides.

• Take proper rest.
• Avoid going in sun.
• Use SPF-15-50 depending upon the skin.
• Practice yoga and stress managing techniques.
• Education about lupus and self care.
• Regular eye examination.
• Avoid going in sun.
• Regular moderate exercise.
• Wear protective clothing and headgear when going out.
• Keep away from people who have known infection.
• Quit smoking.
• Avoid alcohol.
• Maintain healthy diet.
• Eat much of antioxidant rich foods.
• Vitamin D supplements helps a lot.
• Avoid coffee or caffeine containing ingredients.
• Maintain good hygiene level.
• Join support group.
• Counseling by psychiatrist for depression, or if over stressed.
• Take proper medicine and maintain proper chart of medication.
• Preventive heart care.
• Regular immunization.

Homeopathic treatment for Discoid Lupus Erythematosus (DLE)/ Lupus Erythematosus Chronicus Discoides.

Arsenicum Album:
• Burning pains.
• Right side of body affected.
• Itching, burning, swellings, oedema.
• Epithelioma of the skin.
• Mucous membranes such as lungs, spleen etc are

Apis Mellifica:
• Red burning rashes. Associated with fluid retention
• Carbuncles with burning, stinging pains.
• Hot swollen joints and edema.
• Better from cold applications.

Hydrocotyle asiatica:
• Hypertrophy and induration of connective tissue.
• Lupus when there is no ulceration.
• Dry eruptions, circular spots with scaly edges.
• Lupus non-exedens.
• Great thickening of epidermoid layer and exfoliation of scales.

Thuja occidentalis:
• Affects nerves, skin and urinary system.
• Left side of body mainly affected.
• Dry skin with brown spots.
• Eruptions only on covered parts.
• Worse after scratching.
• Worse at night and from heat of bed; at 3a.m.
• Better left side, while drawing up limbs.

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