Do you also experience blue, red, and painful fingers and toes during the cold season, especially when you go to a place like Nuwara Eliya? Do you sometimes develop small sores? Although many people think this is just a common cold, sometimes this can be a condition that requires a little more attention. Today we are talking about 'Chilblain Lupus', a rare but very important type of lupus.
What is Chilblain Lupus?
Simply put, Chilblain Lupus is a rare type of lupus that affects our skin. Medically, we call it ``cutaneous lupus erythematosus or CLE.`` A person with this condition develops painful red or purple lesions, plaques, on the skin when exposed to cold.
The word "chilblain" literally means "cold sore." This is exactly what happens in this condition. Cold weather can cause these symptoms, or make an existing condition worse.
Often, some people develop Chilblain Lupus after being diagnosed with the main type of lupus, ``systemic lupus erythematosus''. However, others may develop the condition without any prior diagnosis. However, the pain and discomfort caused by this condition is quite severe. If you notice itchy, raised spots on your fingers, especially on your fingers and toes, it is best to see a doctor immediately and get treatment.
What are the symptoms of this condition?
Chilblain Lupus is mainly characterized by red or purple patches or lesions on the skin. These are most commonly seen on:
- On the fingers of the hand
- On the heels
- On the soles of the feet
- In the toes
But very rarely, these lesions can also occur on the palms, knees, nose, or ears. All of these are most severe in cold or damp weather.
In addition to these main symptoms, there are several other symptoms that can be seen. Let's see what they are.
| Symptom | A simple explanation |
|---|---|
| Blisters or ulcers | Non-healing wounds on the skin surface due to poor blood circulation. |
| Skin discoloration (Depigmentation) | Some areas of the skin lose their color and become pale. |
| Heel fissures | Deep cracks in the skin of the heels. |
| Thickening of the skin (Hyperkeratosis) | Thickening of the skin where skin lesions have occurred. |
| Raynaud's phenomenon | When exposed to cold, blood flow to the fingers and toes is temporarily restricted. This can cause the fingers to turn white, blue, or red. |
Why does Chilblain Lupus develop? What are the causes?
There are two main causes of Chilblain Lupus. One is genetic , and the other is sporadic .
Hereditary causes
This condition can be caused by certain changes in our genes. In particular, changes in the genes `(TREX1)` and `(SAMHD1)` have been found to affect this. In simple terms, the `TREX1` gene helps in repairing our DNA, and the `SAMHD1` gene is involved in the functioning of our immune system. If there is a defect in these genes, it can be a cause of Chilblain Lupus in the family and in young children.
Occurrence without any reason
For some people, this is not hereditary. It can appear suddenly in adulthood. The exact cause has not yet been found.
Who is at higher risk of developing this?
Although this condition can affect anyone, it is most common in older adults . People who live in areas with a consistently cold, humid climate are also at higher risk.
In addition, some other medical conditions may increase the risk of developing Chilblain Lupus.
- Anorexia nervosa: This is a serious, life-threatening eating disorder.
- Intestinal lymphoma: This is a rare type of cancer that occurs in the lymphatic system of our small intestine.
- Pregnancy: Some women are at risk of developing this condition even during pregnancy.
What complications can occur if left untreated?
If this condition is not treated properly, the skin wounds can become infected with bacteria . These people are at increased risk of developing skin infections such as ``cellulitis``.
Also, a person with Chilblain Lupus may eventually develop systemic lupus erythematosus, the most severe form of lupus that affects multiple systems in the body.
This is why we say that if you notice anything unusual on your skin, especially a wound that doesn't heal, you should not ignore it and see a doctor.
How does a doctor diagnose this exactly?
If you have these symptoms, you may be referred to a dermatologist or rheumatologist .
The main test to diagnose this disease is a skin biopsy . This involves taking a very small piece of skin from a lesion on your skin and examining it under a microscope in a laboratory. This test can confirm whether you have Chilblain Lupus or another skin disease.
What are the treatments for this?
If your Chilblain Lupus is not too severe, you may just need to protect yourself from the cold. Also, if you smoke, your doctor will definitely advise you to quit. Smoking constricts our blood vessels, which can make these symptoms worse.
If symptoms are moderate or severe, the doctor may prescribe various medications.
| Drug type | The work that it does |
|---|---|
| Antibiotics | To treat bacterial infections of skin wounds. For example: `dicloxacillin`, `erythromycin`. |
| Antimalarial agents | To reduce inflammation, fatigue, and joint pain in the body. For example: `hydroxychloroquine`. |
| Immune-controlling drugs (Calcineurin inhibitors) | To reduce the activity of the immune system and control inflammation. For example: `tacrolimus`, `mycophenolate mofetil`. |
| Calcium channel blockers | To open blood vessels and facilitate blood flow. For example: `nifedipine`. |
| Steroid ointments | To reduce swelling and inflammation of the skin. For example: `fluocinolone acetonide`. |
| Systemic steroids | To reduce swelling and inflammation throughout the body. For example: `prednisone`. |
Very rarely, your doctor may recommend surgery. This involves surgically removing the lesion and replacing it with a skin graft from another healthy area of the body.
When should I see the doctor?
If you notice red or purple, itchy, or painful sores on your fingers or toes, heels, or soles of your feet, see a doctor without delay . He or she will be able to diagnose your condition and begin the necessary treatment.
When you see the doctor, you can also ask these questions:
- "Doctor, what could be the biggest reason why I'm developing this?"
- "Is it possible for me to develop systemic lupus?"
- "What should I do to prevent these injuries from occurring?"
- "What can be done about the current injuries?"
Can Chilblain Lupus be prevented?
The best thing you can do to reduce your risk of this condition is to protect yourself from the cold . To do this, you can follow these things.
- Exercise regularly: Exercise improves blood circulation and regulates body temperature.
- Keep your home and workplace warm: Adjust your environment to protect yourself from the cold.
- Soak your hands and feet in warm water: Doing this several times a day will improve blood circulation.
- Warm up cold limbs gradually: Don't do things like suddenly touching them to a fire. Warm up gradually to restore blood flow.
- Wear warm clothes: Wear thick socks, gloves, and warm shoes when in cold environments.
Like other skin conditions, Chilblain Lupus can cause difficult symptoms and sometimes take a while to find the right treatment. But don't give up hope. Working with a doctor you trust can help you find a solution that works for you. In the meantime, joining a support group where you can talk to others who have the same condition can be a great help.
Take-Home Message
- Chilblain Lupus is a rare skin condition that causes painful purple/red lesions on the skin that are exacerbated by cold.
- If you notice these symptoms in your limbs, don't ignore them as normal and seek medical advice as soon as possible.
- The most important thing to prevent and control this condition is to protect yourself from the cold.
- It is very important to completely avoid smoking, as smoking constricts blood vessels and worsens symptoms.
- Although this is a lifelong condition, with proper treatment and care, symptoms can be well controlled and a normal life can be lived.
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