Among the more than 80 autoimmune diseases that exist, some of them can have skin involvement, such as lupus erythematosus, vitiligo, celiac disease (dermatitis herpetiformis), psoriasis, sarcoidosis, scleroderma, dermatomyositis, vasculitis, Behçet’s disease, pemphigus or pemphigoid.
Why is this?
Autoimmune diseases are due to the fact that our own immune system (our defenses, which in theory should protect us) attacks healthy cells in our body, among which may be located in the skin, resulting in different clinical manifestations.
What type of lesions do these skin diseases produce and when can we relate that they are a consequence of the other disease?
Cutaneous manifestations are varied and can sometimes be the guiding sign or the first symptom that makes us suspect a systemic disease.
There are autoimmune diseases that only affect the skin, the paradigmatic example would be vitiligo where there is a loss of pigmentation of the skin, with white patches appearing in different areas of the body.
Diseases such as pemphigus and pemphigoid produce, for example, blisters on the skin.
On the other hand, there are other diseases that can affect other organs in addition to the skin, such as lupus erythematosus. In lupus erythematosus there is inflammation of the skin with reddish and sometimes scaly plaques.
How should these lesions be treated?
The dermatologist, depending on the type of disease, will apply the most appropriate treatment for each entity. In general, as these are diseases in which our defenses are attacking us, we should try to reduce or minimize this inflammation with immunosuppressive or immunomodulatory drugs, such as topical and oral corticosteroids, calcineurin inhibitors (tacrolimus and pimecrolimus), methotrexate, colchicine or antimalarial drugs such as hydroxychloroquine.
The course of autoimmune diseases is generally chronic, but varies widely depending on the individual susceptibility of each person, so there are patients who may have symptoms continuously and others who have flare-ups, with periods of remission of the disease.