You’ve likely heard of autoimmune diseases but may not be familiar with what exactly they are. In general terms, autoimmunity is when your immune system mistakes certain parts of your body as foreign, attacking healthy cells as a result.
As there are various of diseases that fall under this umbrella, Summit Health dermatologist Dr. Andrew Jensen offers helpful insights on autoimmune conditions that specifically target the skin.
The basics of autoimmune skin diseases
“If you have an autoimmune skin condition, you’ll see an inappropriate amount of inflammation on the skin,” Dr. Jensen explains. Depending on the disease type, there may be additional symptoms as well, from swollen joints to tightening of the skin.
Alopecia areata (AA) is a common autoimmune condition that affects hair follicles. Certain immune cells target hair follicles causing the hair shaft to fall out. This leads to complete loss of hair usually in small coin-size patches. Dr Jensen mentions, “these round patches are commonly found on the scalp but can also appear on the face and beard area. When the entire scalp is involved, we call this alopecia totalis. Alopecia universalis is complete loss of scalp and body hair.”
Dr Jensen further explains that “alopecia areata is usually not permanent and treatments exist that can help these patients restore normal hair growth.” Topical anti-inflammatory creams can be used to stave off the attacking cells. Injecting anti-inflammatory medication into affected skin areas is another effective treatment.
Lupus of the Skin
Also known as cutaneous lupus erythematosus, lupus of the skin is uncommon and presents in different ways depending on the subtype: acute, subacute, or chronic. “Symptoms are wide-ranging,” notes Dr. Jensen. They can include:
- Redness across the cheeks and nasal bridge (often referred to as a butterfly rash)
- Generalized redness across sun-exposed skin
- Scaly red plaques on the face, neck, ears, and scalp
There is one characteristic all types of lupus of the skin have in common, explains Dr. Jensen: “Those with it are very photosensitive,” he says. “UV light triggers the disease.” For that reason, those with lupus of the skin should avoid peak sun hours. If they are in the sun, they should apply SPF 50 every 90 minutes to two hours. Other treatments include:
- Topical or systemic steroids
- Antimalarial agents such as hydroxychloroquine
“Scleroderma is a general term that refers to several diseases,” Dr. Jensen notes. “But when people refer to this, they are normally referring to systemic sclerosis.”
“This is a rare condition,” he adds. “There are less than 200 cases per million adults.”
Symptoms to look out for include:
- Tightening and thickening of the skin, which normally starts on the hands or face.
- Difficulty in moving fingers
- Trouble opening the jaw
“Other organs may be affected, including the lungs, heart, and kidneys,” Dr. Jensen says. “So, routine monitoring of these organs is essential. And treatment depends on the severity of skin disease and whether other organs are affected.” Treatment options are immunosuppressive medications delivered orally or through infusion.
If you have concerns that you may have an autoimmune skin disease, make an appointment with your Summit Health dermatologist for an examination.