Q. The biopsy of my skin rash showed interface dermatitis with mucin. Do I have lupus?

Answered by
Dr. Naval Mendiratta
and medically reviewed by iCliniq medical review team.

Hello doctor,

I am a 43 year old female, and I have had itchy, red, and burning rashes. It all started as a few bumps on my right arm, above my eyebrow, right upper nose area, all over the jaw and chin area, right chest and upper back react badly to the sun, and it is getting worse. I have had a lot of blood works done, which were all negative for lupus and other things, although I had a high hs-CRP. I have only one grandmother with a history of severe neurodermatitis, and I had asthma when I was younger. I am worried because of a sun exposed rash which was finally biopsied, showed an interface dermatitis with mucin and suggests either lupus, tumid lupus, dermatomyositis, a connective tissue or collagen vascular disorder, even though no vasculitis is seen. I am worried sick. Is a biopsy conclusive for these diseases? Do I have any one of these diseases? I feel that these rashes are hormonal, but it does not go away and gets worse during PMS and if I consume alcohol. I have no family history of lupus nor any other one of these. I have no muscle issues. However, there is some red discoloring on my fingers. I do take Cipro on and off for diverticulitis. Applying any form of steroids cream helps with the itching, and then makes it even worse. Please help.

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Dr. Naval Mendiratta

MBBS., MD MEDICINE., FELLOWSHIP IN RHEUMATOLOGY
Rheumatology

Hello,

Welcome to icliniq.com.

  • The rashes that you are describing along with the biopsy findings can go in favor of a connective tissue disease. Although, I would like to see the reports in detail, but as you mentioned interface dermatitis, it goes more in favor of lupus over dermatomyositis. But, we need to see a few more things before coming to a conclusion. I am not sure about your lab workup, but I will recommend you get a few test which will help us distinguish between the two.
  • For lupus, you do not need to have a family history. Rashes are one of the first symptoms to appear and we just need to see where it is heading. Even if it is dermatomyositis, sometimes rash can appear few months before muscle weakness. Moreover, the treatment remains same for both conditions.
  • I suggest you avoid sun exposure and use sunscreen with SPF 50.
  • If you could attach the pictures of the rashes, especially the finger ones, and the labs, it would be useful for me. Did you have any history of oral ulcers or hair fall, joint swelling and pains, weight loss, and appetite loss?

Revert with more information to a rheumatologist online --> https://www.icliniq.com/ask-a-doctor-online/rheumatologist

Hello doctor,

Thank you for replying.

Dr. Naval Mendiratta

MBBS., MD MEDICINE., FELLOWSHIP IN RHEUMATOLOGY
Rheumatology

Hi,

Welcome back to icliniq.com.

You are most welcome.

For more information consult a rheumatologist online --> https://www.icliniq.com/ask-a-doctor-online/rheumatologist

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