Well, the winter season is definitely interesting for those of us living in a humid country because it’s fun to think about snow and cool temperatures. It certainly isn’t fun to those who suffer from medical conditions that can be influenced by cold weather or temperature, as amusing as it may seem. People who easily get affected by cold temperatures such as chilblain might want to ask a doctor when they have health problems caused by such conditions. Speaking of chilblain, we will learn more about chilblain lupus.
Before knowing more about chilblain lupus, you might want to understand what chilblain is in general. Chilblains are characterised by small, itchy and painful lumps on the skin. It is an abnormal reaction towards low temperature or cold conditions. Such temperature triggers reduction of blood flow to the skin. This is a way of the body trying to preserve the body heat from escaping to the surroundings. Chilblains often occur after exposure to cold but not to freezing temperatures.
Chilblain lupus is chilblain that can be found in those with lupus. Lupus or well known as systemic lupus erythematosus (SLE) is an autoimmune disease that involves several body systems which in general is associated with high number of morbidity and mortality. An autoimmune disease means the immune system of a person attacks its own body tissue causing great inflammation and damage. SLE is not easy to diagnose as there are numerous unspecific signs or symptoms leading to SLE. Among the common signs or symptoms of SLE are muscle and joint pain, fever, rashes, chest pain, hair loss, light sensitivity, kidney problems, mouth sores, extreme fatigue, anaemia, eye disease, memory problems and blood clotting. SLE is a disease that can never be cured in total but can be controlled by its complications. Hence, it is important to know signs of a lupus to help a person get medical advice immediately and to help treat the disease better.
Chilblain lupus is caused by the cold temperature triggering the vasoconstriction or micro injury to the blood vessels and blockage to the blood circulation. This then leads to blood being thick and stuck in the skin. This situation is aggravated by the changes to the blood flow caused by the autoantibodies of the lupus itself. It is said that the main cause of chilblain lupus is genetic changes such as TREX1 or SAMHD1.
Chilblain lupus appeared as red or dusky purple patches or bumps after exposure to cold and moist climate. The skin lesion can be itchy and painful. Common sites for the skin lesion are fingers, toes, heel and sole of the feet. Less common sites are nose, ears, palms, knuckles, elbow, knee and lower leg. Beside the rash, it may appear with deep cracked skin (fissures) and ulcers. Raynaud’s phenomenon may occur. This phenomenon refers to the temporary blood restriction to the fingers and toes.
Chilblain lupus need to be treated to avoid complications. Common complications are bacterial skin infection and koebnerization (appearance of the new skin lesion on previously unaffected skin due to trauma). The best way to know if the chilblain are lupus chilblain or not is to get checked by a doctor. The thing about chilblain lupus is people may not even know they actually have SLE. Thus, getting diagnosed for chilblain lupus can help patient to understand more about their disease and lower the chances for a full blown SLE.
Chilblain lupus may develop years after the appearance of discoid lesions but may occur simultaneously with discoid lesions. characterised rash or acne-like with scaly dry surface that evolve into larger coin-shaped plaques. It is often seen around the face such as nose, cheek, lip, eyelids and neck area but may also be distributed across the front chest, upper back and back of the hand. The rash generally does not exhibit any symptoms but at times it can be itchy and sore. As discoid lupus expands, it may cause some part of the skin to be hyperpigmented (excess skin pigmentation), leaving a spot of scarring with hypopigmentation (lack of skin pigmentation) and prominent fine pink or red line of visible blood vessels colour known as telangiectasia. In regions with hair such as the scalp, scale or follicular plugging at the hair follicle can be seen and scarring alopecia (hair loss) may be found.
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Treatment for chilblain lupus includes protection from cold, topical steroids, topical calcineurin inhibitors and calcium channel blockers. Protection from cold is important whenever possible. Ensuring home and work stations are well insulated and heated can help control the cold temperature. Best to wear gloves, socks and comfortable gear when being in the cold. Regular physical activity can help to maintain the warm core body temperature. In severe cases, surgery may be needed to repair the area affected by the chilblain lupus. Oral immunosuppression medication may be given in case topical treatment does not work.
