Lupus: Open Access
Open Access

The Prevalence and Features of Discoid Lupus Erythematosus Skin Lesions in Black Patients

Laura Lyons^{* *}Correspondence: Laura Lyons, Department of Clinical Medicine, University of Cambridge, Cambridge, United Kingdom, Email:

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Description

Epidemiological studies have showed that Discoid Lupus Erythematosus (DLE) is more common and prevalent among Black people. Black DLE patients have more disease damage sooner in their disease course.

DLE is a type of chronic Cutaneous Lupus Erythematosus (CLE) that begins with erythematous scaly plaques and progresses to dyspigmentation and scarring. DLE lesions are commonly found on the scalp, ears, and cheeks. Epidemiological research indicates that DLE is more common and prevalent in Black people. Black patients may also present with more disease damage early in the course of their condition. However, the racial disparities in clinical presentation among DLE patients are little understood.

Understanding the ethnic differences in dermatological disease presentations is crucial for resolving inequities. Skin lesions in racially and ethnically minority groups are more severe and resolved with more dyspigmentation in psoriasis. Furthermore, Black and Asian people may have greater scalp psoriasis. Recognizing these racial and ethnic disparities in psoriasis has given researchers a better understanding of the biopsychosocial variables that impact disease presentation and prognosis.

Recognizing ethnic variations in dermatological illness and understanding the factors that cause differences may be important to patients as well. One group of Black patients with dermatological condition expressed greater satisfaction with doctors believed to be more knowledgeable about Black patients' skin and hair. Patients emphasized the significance of physician understanding of variances in cultural, environmental, and societal aspects impacting the skin and hair of Black patients.

Evaluation of DLE manifestation and how it differs in Black patients in order to offer clinicians with a better understanding of which components of DLE might be more prevalent in Black patients and to assist clinicians in providing more effective recommendations to Black individuals who have DLE.

In Black individuals, dyspigmentation was a major characteristic of DLE. Although this study only looked at the existence or lack of dyspigmentation, not its severity, dyspigmentation may be more visible in individuals with darker skin types due to the nature of CLASI (Cutaneous Lupus Erythematosus Disease Area colour, and individuals with darker skin may develop more frequent and severe dyspigmentation irrespective of ethnicity. Increased difference with neighbouring unaffected skin could render hypopigmentation more visible, whereas hyperpigmentation can become more visible among individuals with darker skin types due to higher melanin production. can address pigmentary concerns with patients and offer solutions for enhancing the appearance of dyspigmentation, such as aesthetic concealment, anytime it is unpleasant.

Black patients were also more likely to have scalp and ear involvement, as well as ear dyspigmentation, scalp dyspigmentation, and scarring alopecia. Given that both patient groups reported equal disease activity and follow-up duration, it is probable that Black patients with DLE develop skin deterioration of the scalp and ear quicker than non-Black patients. It is unknown what factors encourage higher scalp inclusion and damage in black DLE patients, but it is believed to be complex. Cultural haircare practices among black individuals might lead to more frequent and severe scarring alopecia, particularly because DLE lesions can koebnerize. Other types of alopecia that disproportionately affect Black patients include traction alopecia and central centrifugal cicatricial alopecia. Cultural haircare practices have been linked to the pathogenesis of traction alopecia, whereas genetics and cultural haircare practices have been linked to the pathogenesis of central centrifugal cicatricial alopecia. Factors that contribute to scalp and ear involvement and damage in DLE merit additional investigation.