Rashes and Autoimmune Diseases

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WHEATON • ROCKVILLE • CHEVY CHASE • WASHINGTON, DC Rashes and Autoimmune Diseases By Rachel Kaiser, MD, MPH, FACR, FACR Arthritis and Rheumatism Associates, P.C. ARTHRITIS As rheumatologists, we often work that are taken by mouth such as with our colleagues in dermatology hydroxychloroquine (Plaquenil), AND to diagnose and treat autoimmune quinicrine, and mycophenolate RHEUMATISM diseases. Rashes can be seen in many mofetil (Cellcept). ASSOCIATES, P.C. of the diseases we treat including scleroderma, vasculitis, lupus and dermatomyositis. Board Certified Rheumatologists Herbert S.B. Baraf Lupus MD FACP MACR Many physicians and patients are Robert L. Rosenberg MD FACR CCD aware of the classic malar (over Evan L. Siegel cheeks and nose) rash seen in MD FACR systemic lupus erythematosus (SLE Malar rash (redness with overlying scale, sparing the areas near the nose) Emma DiIorio or lupus) that can be triggered by MD FACR exposure to sunlight. Many other David G. Borenstein rashes, however, can be seen in lupus, MD MACP MACR including a diffuse circular rash Alan K. Matsumoto known as subacute cutaneous lupus MD FACP FACR erythematosus (SCLE) and a scarring David P. Wolfe rash often seen on the scalp called MD FACR discoid lupus (see images below). Paul J. DeMarco The discoid rash may exist without MD FACP FACR lupus affecting other parts of the Subacute Cutaneous Lupus Erythematosus Shari B. Diamond body such as the kidneys and joints. (SCLE) MD FACP FACR It is often treated by dermatologists Ashley D. Beall with local steroid injections. This MD FACR rash must be evaluated immediately Angus B. Worthing because, unlike other lupus rashes, it MD FACR can cause scarring. Guada Respicio MD MS FACP FACR Medications used for these lupus Justin Peng rashes include topical steroid creams MD FACR and, if necessary, medicines that help Rachel Kaiser MD MPH FACP FACR control an overactive immune system Discoid Lupus Erythematosus (DLE) Nicole Saddic Thomas MD FACR CENTRAL CALL CENTER 301.942.7600 www.washingtonarthritis.com ARTHRITIS AND RHEUMATISM ASSOCIATES, P.C. Board Certified Rheumatologists Dermatomyositis Dermatomyositis is a systemic Dermatologists often help to establish At Arthritis and Rheumatism autoimmune disease that often this diagnosis and may do a skin Associates, PC, we work closely with begins with arm and leg weakness as biopsy to exclude other potential your dermatologist to manage any well as several different rashes causes of these rashes including cancer, rash that may be part of an including: a rash on the hands allergic reactions to medications, and autoimmune disease. n (Gottron’s), around the eyes urticaria (hives). (heliotrope), and/or across the back and chest (shawl rash; see images at Treatment usually involves steroids right). Diagnosis can be established taken by mouth and medicines to with a history and exam, a skin and/ suppress the immune system such as or muscle biopsy and lab tests. methotrexate, azathioprine or mycophenolate mofetil (Cellcept). Dermatomyositis Rashes: Gottron’s Heliotrope Shawl PHOTO SOURCE: AMERICAN COLLEGE OF RHEUMATOLOGY CENTRAL CALL CENTER 301.942.7600 www.washingtonarthritis.com.

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