How often does discoid lupus turn into systemic lupus?
- The above photo is a classic example of discoid lupus
- Around 15% of people with systemic lupus erythematosus (SLE) will also have discoid lupus erythematosus (DLE)
- If someone develops DLE by itself, it can potentially evolve to SLE over time
- SLE will develop in 25% to 30% of children who have DLE
- In adults, it depends upon how extensive the DLE is:
- if the DLE is just above the neck (localized DLE), that person has approximately a 10% chance of SLE
- If the DLE is above and below the neck (generalized DLE), there is a 1 out of 4 chance of evolving to SLE
A ray of hope
- People who have DLE that evolves to SLE tend to have a milder form of SLE. They are less likely to have severe organ involvement, such as lupus nephritis (kidney inflammation) compared to SLE patients who do not have DLE
- However, this rule is not 100%. There are some DLE patients who will develop severe SLE. This more commonly occurs in those with severe DLE that is generalized.
- Make sure to follow all the advice in the "Lupus Secrets" to ensure you have the greatest chance of not developing severe SLE
If you have discoid lupus... what is your experience and advice for others. COMMENT above
The above photo is courtesy of Johns Hopkins Press upcoming 2nd edition of "The Lupus Encyclopedia"
Arkin LM, Ansell L, Rademaker A, et al. The natural history of pediatric-onset discoid lupus erythematosus. J Am Acad Dermatol. 2015;72(4):628-633. doi:10.1016/j.jaad.2014.12.028
Chong BF, Song J, Olsen NJ. Determining risk factors for developing systemic lupus erythematosus in patients with discoid lupus erythematosus. Br J Dermatol. 2012 Jan;166(1):29-35. Epub 2011 Dec 5.
Izmirly P, Buyon J, Belmont HM, et al. Population-based prevalence and incidence estimates of primary discoid lupus erythematosus from the Manhattan Lupus Surveillance ProgramLupus Science & Medicine 2019;6:e000344. doi: 10.1136/lupus-2019-000344
Pons-Estel, G. J., Aspey, L. D., Bao, G., Pons-Estel, B. A., Wojdyla, D., Saurit, V., … Drenkard, C. (2017). Early discoid lupus erythematosus protects against renal disease in patients with systemic lupus erythematosus: longitudinal data from a large Latin American cohort. Lupus, 26(1), 73–83. https://doi.org/10.1177/0961203316651740
Note that Dr. Thomas' posts are for informational purposes only, and are not meant to be specific medical advice for individuals. Always seek the advice of your healthcare provider with any questions regarding your own medical situation.
DONALD THOMAS, MD