What Are Autoimmune Skin Diseases And How Do They Happen?

Are you experiencing unexplained skin changes? Your immune system may be acting up. 

Our immune system plays a crucial role in protecting our bodies from bacteria and viruses. But sometimes, it can mysteriously go awry and mistakenly attack our own tissues instead of targeting foreign threats. This is known as an autoimmune disease.

What Is an Autoimmune Disease?

An autoimmune disease occurs when the immune system attacks healthy cells. In the case of autoimmune skin diseases, these healthy cells are found in the skin.

While the exact cause of autoimmune diseases remains a subject of ongoing research, experts believe it involves a complex interplay of genetic and environmental factors. Some potential triggers and risk factors may include:

• A family history of autoimmune diseases can increase your risk
• Exposure to certain toxins, infections, or stressors may contribute to the development of autoimmune conditions
• Fluctuations in hormones, such as during pregnancy or menopause

Common Autoimmune Skin Diseases

Psoriasis

Psoriasis is a chronic skin condition that causes skin cells to grow too quickly. This rapid growth leads to a buildup of thick, scaly patches on the skin’s surface, which can be itchy, painful, and sometimes even embarrassing.

The severity of psoriasis can vary significantly from person to person. Some individuals may experience only mild symptoms, while others may have severe psoriasis that affects a large portion of their body. In severe cases, psoriasis can lead to significant physical and emotional distress.

The symptoms of psoriasis can vary depending on the type of psoriasis you have. For instance, if you have plaque psoriasis, you will see raised, red, scaly patches on the skin, while pustular psoriasis appears as blisters or bumps filled with pus near or inside red skin blotches.

Vitiligo

Vitiligo causes loss of pigment, resulting in white patches on the skin. It occurs when melanocytes, the cells responsible for producing melanin (the pigment that gives skin its colour), are destroyed or stop functioning. 

Vitiligo can progress in different ways. In some cases, the white patches may remain stable, while they may continue to grow and spread in others. The rate of progression varies from person to person.

The symptoms include:

• White patches, which vary in size and shape and may appear anywhere on the body
• Loss of colour within the patches
• Sun sensitivity
• Hair loss in the affected areas

Lupus of the skin

Skin lupus, also known as cutaneous lupus erythematosus (CLE), is a skin condition that occurs in people with systemic lupus erythematosus (SLE). SLE is a chronic autoimmune disease that affects multiple organs, including the skin.

The symptoms of skin lupus can vary depending on the type you have, further discussed below. 

Discoid Cutaneous Lupus is characterised by round, disk-shaped, thick, scaly, and red lesions, which can be painful, itchy, or burning but may also be asymptomatic. They commonly appear on the face, ears, and scalp.

A significant concern with this type of skin lupus is it can persist for years and may lead to scarring, discolouration, or hair loss. Also, lesions that have been present for a long time may increase the risk of skin cancer. 

Subacute Cutaneous Lupus has red borders around the edges of lesions, often with a darker red circle on the outer edge. These lesions typically appear on the neck, chest, upper back, shoulders, and arms, often after sun exposure. They do not usually cause pain, itching, or scarring but can lead to skin discolouration.

Acute Cutaneous Lupus often presents as a malar rash or “butterfly rash” across the cheeks and bridge of the nose, frequently triggered by sun exposure. While scarring is uncommon, skin discolouration may occur. 

Note that the characteristic “butterfly rash” is a sign of systemic lupus, indicating potential symptoms in other body areas. If you develop this rash, consult with a healthcare professional for further evaluation.

Dermatomyositis

Dermatomyositis is actually a systemic autoimmune muscle disease that causes skin problems. 

The skin rash associated with dermatomyositis is often described as a “heliotrope rash” due to its purplish-red colour. It typically appears on the eyelids but can also affect other areas of the face and body. 

Besides the heliotrope rash, people with dermatomyositis may also develop Gottron’s papules, which are small, red bumps on the knuckles.

Alopecia Areata

Alopecia areata is the autoimmune disorder that causes hair loss in patches. These patches can vary in size and shape and may appear anywhere on the scalp. 

In some cases, the hair loss may be complete, resulting in a condition known as alopecia totalis or alopecia universalis.

Alopecia areata does not pose a threat to physical health and, in most cases, is not life-threatening. But, some individuals may experience psychological distress due to the cosmetic impact of hair loss.

Dermatitis Herpetiformis

Dermatitis herpetiformis is a skin condition associated with celiac disease, an autoimmune disorder triggered by gluten consumption, a protein found in wheat, barley, and rye.

Its symptoms include:

• Itchy, blistering skin eruptions typically on the elbows, knees, buttocks, and scalp
• Burning sensation on the affected skin
• Pain in severe cases

Bullous Pemphigoid

Bullous pemphigoid is an autoimmune blistering disease that causes large, fluid-filled blisters on the skin. Before the blisters appear, you may experience itching for weeks or months. Then blisters will form along creases or folds in the skin. They are typically tense and do not rupture easily.

The skin around the blisters may appear normal, reddish, or darker than usual. Some people with bullous pemphigoid may also develop eczema or a hive-like rash. Small blisters or sores may sometimes form in the mouth or other mucous membranes, a condition known as benign mucous membrane pemphigoid.

It can be a chronic condition lasting several months or even years. In some cases, the condition may resolve on its own, while in others, it may persist or recur.

Morphea/Scleroderma

Morphea, also called scleroderma, is a rare condition that causes painless, discoloured patches on the skin, often appearing on the belly, chest, or back. These patches may gradually become firm, dry, and smooth. While morphea typically affects the outer layers of the skin, some forms can also impact deeper tissues and restrict joint movement.

The signs and symptoms of morphea vary depending on the type and stage of the condition. Reddish or purplish oval patches often develop on the belly, chest, or back, gradually acquiring a lighter or whitish centre. Linear patches may appear on the arms, legs, forehead, or scalp. Over time, the affected skin becomes firm, thickened, dry, and shiny.

Morphea can cause several complications, including self-esteem issues due to the cosmetic effects on the skin, movement problems in the arms or legs, widespread areas of hardened, discoloured skin known as generalised morphea, loss of hair and sweat glands in the affected area, and potentially permanent eye damage in children with head and neck morphea.

Pemphigus

Pemphigus is a group of autoimmune blistering diseases that cause painful, erosive blisters on the skin and mucous membranes. 

There are two main types of pemphigus:

• Pemphigus vulgaris: This is the most common type of pemphigus, characterised by large, fluid-filled blisters that can appear anywhere on the body.
• Pemphigus foliaceus: This type is characterised by smaller, superficial blisters that are often crusted over.

Pemphigus is often confused with bullous pemphigoid but differs in blister formation and severity. Pemphigus blisters tend to be superficial, easily ruptured, and often accompanied by erosions, while bullous pemphigoid blisters are typically larger, tense, and less likely to rupture.

Pemphigus can be a severe and life-threatening condition if left untreated; bullous pemphigoid is generally less severe, although it can still cause significant discomfort.

When To See A Dermatology Clinic For Autoimmune Skin Disease Symptoms

If you are experiencing any of the following symptoms, consult a dermatologist immediately for evaluation. Early diagnosis and treatment can help to prevent complications and improve your quality of life. 

• If you have skin symptoms that are not improving or are getting worse
• Any unusual skin changes, such as new rashes, blisters, or discolouration
• If you are experiencing systemic symptoms, such as fatigue, fever, joint pain, or weight loss, in addition to skin symptoms
• If your skin condition is causing significant psychological distress

If you have a family history of autoimmune diseases and you have at least one of the symptoms above, you may be at increased risk for developing an autoimmune skin condition.

Managing Autoimmune Skin Diseases

Managing autoimmune skin diseases often involves a combination of medical treatments and lifestyle modifications. The specific approach will depend on the type of disease, its severity, and the individual’s overall health.

Medical Treatments

• Topical medications, such as corticosteroid creams and ointments to help reduce inflammation and itching
• In severe cases, systemic medications such as immunosuppressants or antimalarial drugs to suppress the immune system
• Narrowband UVB phototherapy for treating certain autoimmune skin diseases, such as psoriasis and vitiligo

Lifestyle Modifications

• Stress management techniques to avoid exacerbating autoimmune skin diseases 
• Gentle skin care routines to soothe irritated skin and prevent infections
• A healthy diet to support overall well-being and manage autoimmune skin diseases
• Regular physical activity to boost mood, reduce stress, and improve overall health

Autoimmune Skin Disease Care at ENRICH

Working closely with your dermatologist is necessary to develop a personalised management plan that addresses your specific needs and goals.  Make a booking with us to help manage your autoimmune skin disease.