Autoimmune diseases represent a category of conditions in which the immune system mistakenly attacks the body. In other words, the immune system identifies parts of the body, such as the joints or skin, as foreign.
The skin will sometimes hint at what’s going on beneath the surface in certain autoimmune conditions. Here are a few common autoimmune diseases that will show up on your skin.
Lupus
Also known as systemic lupus erythematosus (SLE), lupus is a chronic autoimmune disease that can affect any part of the body, but usually targets the joints, brain, kidneys, and the skin. Characterized by inflammation throughout the affected areas, lupus also causes joint pain and often arthritis.
Lupus patients generally display a butterfly-shaped rash on their faces that covers the cheeks and the bridge of the nose. Sometimes they will have rashes elsewhere on the body. SLE causes the patient’s skin to be hypersensitive to the sun, increasing the risk of skin problems caused by overexposure to the sun. Small amounts of sunlight can create scaly patches across the skin that can scar over. It is these scarred sections of skin that have an increased risk of developing carcinoma and melanoma, the two common forms of skin cancer. Lupus patients are advised to wear protective clothing as well as a high SPF sunscreen.
Discoid lupus erythematosus (DLE) is a form of lupus that mainly affects the skin. These patients will have red, scaly patches that often cause scarring. DLE patients only rarely, approximately 5-10%, develop systemic issues.
Scleroderma
Scleroderma is a chronic connective tissue disease that causes extreme hardening of the skin, caused by vast overproduction of collagen. There are two main types of scleroderma: localized scleroderma and systemic scleroderma.
Changes caused by localized scleroderma are seen in only a few places on the skin and seldom spread. Localized scleroderma is the milder side of the disease; internal organs are rarely affected, and the patient usually does not develop systemic scleroderma later on.
Systemic scleroderma causes changes that affect connective tissue throughout the body and can affect every internal organ, as well as blood vessels and joints. Systemic scleroderma is also split into two categories:
- Limited Scleroderma: Progresses relatively slowly and affects the skin of the hands, feet, and face. Sometimes damages the lungs, esophagus or intestines.
- Diffuse Scleroderma: Progresses very quickly and affects skin across the entire body. Much higher chance of thickening of internal organs such as the heart, kidney, and lungs that can be fatal.
Treatment usually targets the symptoms or aims to decrease the activity of the immune system.
Dermatomyositis
Dermatomyositis is a chronic disease that causes muscle inflammation, which often leads to muscle weakness. It is one of a group of diseases known as inflammatory myopathies.
The first symptom of dermatomyositis is a skin rash that will appear on the eyelids, nail cuticle areas, and/or on muscles that are used to straighten or extend joints including heels, elbows, and knuckles. The rash is bluish-purple or red and is usually patchy.
Treatment includes medication to manage symptoms, physical therapy, heat therapy, and rest. Physical therapy is recommended to help the patient rebuild muscle strength and to prevent muscle atrophy.
Pemphigoid
This autoimmune disease results in skin rashes and fluid-filled blisters along the legs, arms, stomach, or on the mucous membrane (this includes the mouth, eyes, nose, throat, and genitals). The different types of pemphigoid are characterized by where the blistering occurs on the body, and are called:
- Bullous Pemphigoid: Blistering happens on the arms and legs, mostly around the joints
- Cicatricial Pemphigoid: Blistering occurs on the mucous membrane, typically affecting the eyes and mouth.
- Pemphigoid Gestationis: This is when the blistering occurs shortly after or during pregnancy, usually on the arms, legs, and abdomen.
Treatment commonly involves medication that reduces inflammation, helps heal the blisters, or relieves itching. Some doctors will prescribe immunosuppressants if you are not at great risk for other infections.
Pemphigus
Pemphigus looks very similar to pemphigoid, as they are both characterized by blisters on the skin and/or the mucous membrane. The difference lies in the fact that the immune system attacks a different part of the skin in each disease. The affected part of the skin in pemphigus is more fragile because it is closer to the surface, so any blisters than form burst very easily. Patients have more ruptured blisters than intact and are usually covered with scabs.
Pemphigus is considered a more serious disease since burst blisters present a higher chance of infection, which is dangerous for someone with an already compromised immune system. There are two main types of pemphigus:
- Pemphigus Vulgaris: Blisters begin in the mouth and spread to the skin or genitals. Generally, these blisters are painful but not itchy.
- Pemphigus Foliaceus: Blisters appear of the chest, back, and shoulders. These are usually itchy rather than painful.
Psoriasis
One of the more well-known skin diseases, psoriasis is an autoimmune condition that speeds up the life cycle of skin cells, causing excess skin cells to collect on the surface of the skin. This buildup forms itchy and painful scales and red patches. There are many different types of psoriasis, but some common symptoms include red patches of skin with silvery scales, itchy scaling spots, extremely dry skin that may bleed if it cracks, and swollen and stiff joints. Patches can range in size from a few smaller spots that can look like dandruff, to much larger eruptions.
Psoriasis typically goes through cycles, and patients will experience flare-ups for a short period of time, and then go into remission. Treatment, unfortunately, only helps to manage the symptoms, as a complete cure has not been found yet.
With dermatology offices in Boca Raton and Boynton Beach, Siperstein Dermatology Group offers board-certified dermatologists, physician assistants, and licensed aestheticians to answer all your questions about your autoimmune disease and your skin. Contact us today to schedule a consultation!
