Lupus and your skin: Causes
Some types of lupus are more common in Black people
Research shows that systemic lupus erythematosus is 2 to 3 times more common in women than men and more common in Black Americans than white Americans. Discoid lupus is most common in Black people.
What causes lupus on the skin?
All types of lupus are autoimmune diseases.
An autoimmune disease develops when your immune system attacks part of your own body. For example, if you have the most common type of lupus, systemic lupus erythematosus (SLE), your body may attack the kidneys, skin, or other parts of the body.
Any time lupus affects the skin, your immune system is attacking healthy skin cells.
Researchers continue to study why people get different types of lupus, including the different types of cutaneous (skin) lupus. What researchers have learned suggests that most types of lupus develop when the following happens:
The person inherits one or more genes that increase the risk of developing lupus. These genes can come from their mother or father.
Something triggers (or turns on) these genes.
When lupus affects the skin, common triggers include:
Ultraviolet (UV) light - Sunlight, tanning beds, and fluorescent light bulbs expose you to UV light
Cigarette smoke
An infection
Some medications
Stress
Surgery or a serious injury
Sunlight can cause a lupus flare
People of all skin tones can reduce the number of lupus flare ups they have by protecting their skin from the sun.
Why do certain genes cause lupus?
The genes that can cause lupus contain variants. Researchers have now found more than 100 gene variants that can cause lupus.
A variant can affect the way a gene works. For example, genes that can cause lupus often have variants that affect how the person’s immune system works.
It makes sense that the variants would affect the body’s immune system because every type of lupus is an autoimmune disease.
Even if you inherit gene variants that can cause lupus, it doesn’t mean that you will develop any type of lupus. Researchers are still studying why this happens. The answer could help predict who will get lupus and what treatment will be most effective for them.
What causes neonatal lupus?
Developing in newborns, the cause of neonatal lupus differs slightly from other types of lupus. Instead of inheriting genes for lupus, the baby receives antibodies from its mother that cause neonatal lupus.
Antibodies, which the immune system makes, help the body fight off harmful bacteria, toxins, and other substances. During pregnancy, a mother naturally passes antibodies to her child. Babies inside the womb cannot make antibodies.
While it’s natural for a mother to pass along antibodies, it’s rare for a mother to pass along antibodies that cause neonatal lupus — even if the mother has lupus. Few babies develop neonatal lupus.
Who gets lupus on their skin?
People of all races and ages can get lupus and develop rashes, sores, and other signs of lupus on their skin.
Some people have a greater risk of developing certain types of lupus.
Discoid lupus erythematosus (DLE): Affecting only the skin, DLE is most common in Black people.
Systemic lupus erythematosus (SLE): Black American women have the greatest risk of developing SLE, the most common type of lupus. Hispanic and Asian women have a higher risk of developing SLE than white women.
If you have a blood relative who has lupus, you also have a greater risk of developing lupus.
No matter the type, finding lupus early and getting treatment can prevent the disease from worsening. When lupus affects the skin, this can mean fewer flare-ups and stopping the disease from causing scarring and sometimes permanent hair loss.
To find out how a dermatologist can tell if lupus is affecting your skin and what a treatment plan might look like, go to: Lupus and your skin: Diagnosis and treatment.
Images
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References
Lee LA, Werth VP. “Lupus erythematosus.” In: Bolognia JL, et al. Dermatology. (4th edition). Elsevier, China, 2018: 662-80.
Nozile W, Adgerson CN, et al.” Cutaneous lupus erythematosus in skin of color.” J Drugs Dermatol. 2015 Apr;14(4):343-9.
Oglesby A, Korves C, et al. “Impact of early versus late systemic lupus erythematosus diagnosis on clinical and economic outcomes.” Appl Health Econ Health Policy. 2014 Apr;12(2):179-90.
Sontheimer CJ, Costner MI, et al. “Lupus erythematosus” In: Kang S,et al.Fitzpatrick’s Dermatology. (ninth edition) McGraw Hill Education, United States of America, 2019:1-5037-59.
Written by:
Paula Ludmann, MS
Reviewed by:
Brendan Camp, MD, FAAD
Mario J. Sequeira, MD, FAAD
Last updated: 9/23/22