Is this a discoid lupus lesion?

[milkwoman]

A week ago today, i woke up with a strange lump above my lip. it was firm, a little tender but not itchy. I didn't think much of it - just thought it was a a large pimple or perhaps the result of an ingrown facial hair.

I put on the usual skin ointments that I have to dry out pimples and a few days later was able to peel off a scab - bled like crazy. I applied triple antibiotic gel to it. The next day when touched, it it felt kinda crinkly as if things underneath were "popping" and it seemed to get a little flatter.

I can dry off the top using Burts Bees herbal blemish stick and I can moisturizer it but it just doesn't seem to be healing or going away.

I have SLE. This is the first time I've had anything like this. Not happy that it is on my face!

Sooo, curious if this is a discoid lupus lesion? What can I use to treat it? Is discoid lupus diagnosed via symptoms or is there a test?

Thanks for your help!

[RhondaB]

I have SLE & Discoiled also. Never had a issue like this. Cant say its Discoiled. You may want to contact your Dr or you may want to contact a dermatologist. I may get a small bump but I have Hydrocortisone cream 0.02% that I put on soon as I see it any where on my body and it normally stops it. Hope this helps

[milkwoman in reply to RhondaB]

Thanks Rhonda. I've been reading that hydrocortisone might help. I will get some as well as contact my rheumatologist to see if she can advise. I just didn't want to bother her needlessly.

[EOLHPC]

Hmmmm....Horrid things...for what it's worth: hard to be sure, but the pic & your description do remind me of the so-called "perioral dermatitis" rashes I used to get before lupus meds started in 2011.

I mostly had this sort of thing as individual 'spots' and also more spread out patches beside & below my mouth + anywhere over my chin + under my chin & on my upper neck. Mine started the way you describe and then became sore prickly (but not actually itchy) rough crusty patches. I avoided touching them at all. A v good NHS dermatologist provisionally gave this wrong POD diagnosis...she was v good about apologising when SLE was diagnosed.

My feeling is that my version of these was related to my autoimmune probs because they stopped as soon as systemic treatment for SLE started with daily hydroxy. The year before that began, I had a particularly bad session of my version of this. No dr has ever mentioned discoid lupus. Drs tried various prescrip hydrocortisone creams: none helped me. Only a strong prescrip antibac called dalacin t sort of helped.

Will follow this discussion with interest.Hope you'll let us know what you find out

🍀🍀🍀🍀 coco

[milkwoman in reply to EOLHPC]

I will have to read up on perioral dermatitis as I've not heard of that.

No prickliness at all... Nor itchiness. Started out looking much like an insect bite. Firm and a little tender. I'm terrible with bumps/lumps and cuts, especially if on the face....Hard to face the public so I do what I can to get it to go away as quickly as possible.

Probably should not have "played" with it but as I wrote I thought it was a pimple or ingrown hair so squeezing or digging out the hair leads to quickest healing (at least for me). There is no pus nor liquid nor solid stuff inside - nothing ever came out (it bled because I peeled to top off with the hopes it would then be "flatter).

It's just taking a long time to go away. I wouldn't be surprised if it took a strong antibiotic - seems to be my lot in life. Lupus hates me as is doing everything in its power at the moment to make life miserable for me.

Thanks so much for your help!

[EOLHPC in reply to milkwoman]

Yes, my version of this also seemed to start this way...and really not like any manual interference.

My bumps did the bleeding thing and with time spread while oozing clear stuff, as well as cracking with bits of bloodiness (sorry)

Ask your dr about the topical antibiotic dalacin T.

🍀🍀🍀🍀😘

[milkwoman in reply to EOLHPC]

Looked at perioral dermatitis - all the images show tiny spots so not sure what I have is that.

Looking better today. Hoping it is healing...

[EOLHPC in reply to milkwoman]

You're right: even mine wasn't perioral dermatitis...that's why my Dermy felt she had to apologise when my infant onset lupus diagnosis got recovered...that felt great to me...not often medics apologise 😜🌟🍀

[milkwoman in reply to EOLHPC]

Docs? Apologize?

That is a rare miracle!!! 😜

[EOLHPC in reply to milkwoman]

Yes...and the spooky thing was that shortly after she surprised everyone by retiring early...this was a VVV popular consultant in her prime. Even other consultants mentioned to me how shocked they were. She helped me a lot..and seemed like such a human being...I've often wondered & hoped she is alright...😳

[61Annie]

This looks like the beginnings of a cold sore, I have suffered most of my life with these. Best form of treatment is Zorvirax cream available from your pharmacy.

[milkwoman in reply to 61Annie]

Not a cold sore - those I am familiar with (hate those and their tingling feeling) This began

much like an insect bite, only no itching and firmer.

Thanks for replying !

[EOLHPC in reply to milkwoman]

Me too! The diff is clear!

[Danderson25 in reply to milkwoman]

Mine too I thought my dog had fleas that were biting me but no one in the house had bites. They don’t itch but if I scratch it by accident then it will turn to a inflamed sore that is deep, really weird.

[PMRpro]

Any lesion of any sort that either refuses to heal or which heals and returns repeatedly should be checked by a dermatologist, especially if it bleeds. I personally wouldn't accept a dismissal of something like that by a GP - but first of all, do give it a chance to heal without picking at it. Keep pulling the top off and it can't heal - that is what the scab is for, to protect it while it heals from underneath.

[milkwoman in reply to PMRpro]

I will ask both my rheumy and my GP. Barn clown above gave me something to research as well. I hope to figure it out!

Yes, I know all about "leaving things alone"... You sound like my mom. I've never been able to leave sores alone... Sometimes they heal quicker for me and with less scarring when I pull off the scabs (sort of like what they do with burns).

Thanks for writing!

[PMRpro in reply to milkwoman]

I'm sorry - as I wrote it I thought exactly the same thing

I have small patches of keratosis from taking pred - one is on my shoulder and when I'm lying in bed at night I cross my arms across my chest - and it is just where my fingers rest... I tend to rub it - but luckily it never bleeds, just the tops flakes off a bit.

[milkwoman in reply to PMRpro]

No need to apologize!! I know I shouldn't pick at things... Just can't help myself. If it were not on my face it would be easier to let be.

Looking better today. I put some olive oil moisturizer on it - I read that olive oil is good for lesions. We shall see how it goes.

[Hidden]

My rash spots itch like hell and then crust and are sore, however, I have only ever had one cold sore. As it presented differently I went to the gp (a dermatologist) who said our bodies may react differently to others with the herpes virus, not blister or itch as our bodies cut out the middle man. Mine was raised, sore, crusted and bled. Still get it checked though.

[milkwoman in reply to Hidden]

No itching with this one. I've had plenty of cold sores - this most certainly isn't one.

Today it does look better. Perhaps it is actually healing!

[Hidden in reply to milkwoman]

Good to hear.

[LUPUSadmin]

Hi Milkwoman. As others have said, it's probably best to get this checked out by your doctor. Here's some information I've taken from the Lupus Encyclopedia (Thomas, 2014) about discoid lupus' diagnosis.

'Doctors usually diagnoses lupus rashes by the way they appear on physical examination. However, sometimes a skin biopsy is necessarry to know for sure.'

George

[milkwoman in reply to LUPUSadmin]

Thanks George. It is looking better today. Sending a note to my rheumy.

[actinteach]

Did you ever find out what this was? I have the very same thing on my arm. They just pop up randomly. And I try to get the "Center" out it seems to make a deep hole and the skin seems to slough like a spider bite. Just wondered what you found out.

[milkwoman in reply to actinteach]

Not yet. I see my rheumy on the 9th of August and this is on my list to discuss. After this lesion, I had 4 more instances of them on my face. One left a small crater-like scar and two others are red patches. I haven't had any more pop up (thankfully). I hope my rheumy will be able to tell me what they are, what is causing them and how best to treat if more show up.

[happytulip]

Ok, PLEASE take this advice. Without being alarmist, just because you have Lupus doesnt make everything down to Lupus. The leision on that particular part of your face needs to be looked at as it could well be a basal cell carcinoma. Don't panic!!! It probably isn't but it needs to be ruled out. My mother, uncle and aunt have had several. They looked similar and they were around the mouth. They have been removed with special creams if it is the case but please get this check out asap. As I said, it probably isn't but it does need looking at. As I said, it is very easy to assume that just because we all have a really complex disease that everything in our bodies can be related to it. Please get it checked and let us know how you get on x

[milkwoman in reply to happytulip]

All the lesions I've had went away on their own so I am certain I can rule out carcinoma as skn cancer tends to not do that. The others were on my cheeks and chin.

Thanks for your concern.

[Danderson25]

I have SLE as well and I get these. It take weeks for them to finally heal and then they leave a purple mark for a long time. And hurt so bad it touched, I feel ur pain

[Danderson25 in reply to Danderson25]

I had one on the side of my face that refused to heal and was so painful and seemed to get bigger, I was thinking staph infection. I ended up covering it at night with antibiotic cream and it FINALLY healed

[milkwoman in reply to Danderson25]

This post is 4 years old. Luckily, I haven’t experienced any lesions since this one. In any event, thank you for your reply as it might help others.

[Jmiller623]

I get these from time to time but much much less since starting plaquenil. They are like welts with a small pimple like thing in the middle. Feels like cystic acne but it isn’t. I use those pimple patches to put over it so I don’t rub/touch them. I think they may be caused by some sort of small vessel vasculitis related to SLE. I’ve never tried steroid cream since it shouldn’t be used on the face. Pimple creams including a prescription one does nothing and usually makes it’s worse. Seems like a waiting game, drinking plenty of fluids and just keep on keeping on. Try hard not to rub it.

As always, discuss with your doctor. Especially if lasting longer than 2 weeks.

[milkwoman in reply to Jmiller623]

This post is 4 years old and at the time, I did discuss with my Rheumy as well as my Derm. Luckily, I haven’t experienced any lesions since this one. In any event, thank you for your reply as it might help others.

[Jmiller623 in reply to milkwoman]

Thanks for the heads up milkwoman. These posts get me all the time! Glad you haven’t had any issues since then.