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Heidirenn

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 #1 
Hello,
I am new here and quite frankly, a little scared. :) I had a biopsy on my face by dermatology as I had two marks on my upper cheeks that would not go away with any creams, oral antibiotics etc and the results came back as "consistent with lupus". Would it be rare for a biopsy to be wrong? I am currently waiting to hear back to schedule with rheumatology...more testing to see if this is just skin lupus or systemic. I had graves disease in the past and I also have psoriasis. Do some of you get really tired with the non-systemic lupus too? I am often so tired. Thank you.
Robinj

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 #2 
Welcome
Graves is an autoimmune disorder. I have DLE (discoid lupus), and I do have fatigue. How does your skin issue present? 

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When the first baby laughed for the first time, its laugh broke into a thousand pieces, and they all went skipping about, and that was the beginning of fairies. 
Heidirenn

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 #3 
I have two patches on my upper cheeks...seems almost under the first layer of skin if that makes sense? Not at all like my psoriasis and i have never had psoriasis so far in my face. Not sure how to post a photo etc. and hard to describe, but red/purplish patches...one side is more circular, the other side larger, but still oval/slightly circular. While having coffee with a friend she thought I had a bruise so maybe a little purplish. It started showing up 2 months ago. I had Graves Disease about 14 years ago...had my thyroid burned out with radioactive iodine. Now on synthroid, etc. I have had so much chronic hives and other skin problems through the years. I just turned 40. I do have a faint butterfly rash across my nose and cheeks but not that noticeable...My aunt and a second cousin both have lupus. My aunt is systemic, and my other cousin I think just skin. Thank you so much for the reply. I love the sun...not quite sure what to think yet. I am tired in general...but I do not feel that I have systemic lupus based on the guidelines. I have just had a biopsy that came back "consistent with lupus" and now waiting to have other tests scheduled. One other note...i have three kids and every time I would be pregnant my skin issues would almost completely go away! Could it be because my immune system is suppressed when pregnant...i have found this so interesting but so many Dr's do not seem to make the same correlation when I question this...
Robinj

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 #4 
First of all, if you have lupus or a related autoimmune disorder, the sun is most likely your enemy. Hope you are wearing high SPF sunscreen and covering up. If not, try it and see if your fatigue and other symptoms improve. Unfortunately, many AI issues overlap and a dx is usually not a quick thing. Sun avoidance is key for most of us. I know for myself, not only does it exacerbate my discoid issues, it makes me just sick overall.
The first course of treatment ( Plaquenil) is usually the same regardless of what they choose to call it.  


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When the first baby laughed for the first time, its laugh broke into a thousand pieces, and they all went skipping about, and that was the beginning of fairies. 
Robinj

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 #5 
Also, my issues first became apparent when I was pregnant with my first in 1987. Unfortunately, not much was known then. I was told, I may develop a collagen related disease based on my borderline ANA, which by the way, has never changed....

Hope this helps!

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When the first baby laughed for the first time, its laugh broke into a thousand pieces, and they all went skipping about, and that was the beginning of fairies. 
Heidirenn

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 #6 
Thank you so much. If my biopsy is saying "consistent with lupus" does that mean for sure that I have some type of lupis? I guess I am still hoping they could be wrong. :/ I guess I will learn more when I have my rheumatology appt. Thank you so much for the feedback.
Robinj

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 #7 
You are very welcome! Please keep me posted. Lupus and AI issues in general, can be very hard to dx. Try not to stress too much and stay out of the sun!!!!
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When the first baby laughed for the first time, its laugh broke into a thousand pieces, and they all went skipping about, and that was the beginning of fairies. 
Heidirenn

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 #8 
Ok, thank you :)
upstater

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 #9 
Also, remember that a biopsy only points to what is going on in the skin. You may not have any systemic issues. 

I know it's hard, and believe me....I did not initially and still don't always practice this, but just try and go one day at time.
Heidirenn

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 #10 
Yes, I really feel like it is probably just going on in the skin. I'm just curious if a biopsy can be wrong and I don't have anything...maybe I'm a little in denial. Thank you :)
Robinj

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 #11 
Actually, a biopsy can point to possible systemic issues. 
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When the first baby laughed for the first time, its laugh broke into a thousand pieces, and they all went skipping about, and that was the beginning of fairies. 
Robinj

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 #12 

The biopsy findings in the skin will usually demonstrate inflammation in a particular level of the skin layers (between the dermis and epidermis). Moreover, if special antibody staining tests (immunoflourescent stains for immune deposits) are also performed (take three weeks for results), then antibodies can be noted to be deposited at the junction of the dermis and epidermis. The antibodies form a line of fluorescence when viewed under a microscope and this type of examination has been referred to as a "lupus band test." It is positive when performed in involved skin in 90% of patients.

Interestingly, it is also positive in uninvolved sun-exposed skin in 80% of patients and in uninvolved non-sun-exposed skin in 50%. Therefore, in some settings doctors will do a biopsy of skin of the arm in an attempt to evaluate a facial rash of certain patients with lupus. When this test is abnormal (demonstrates antibodies deposited at the junction of the dermis and epidermis), skin disease from systemic lupus erthyematosus is felt to be present.

There is also some research that describes an increased risk for more serious forms of systemic lupus in those patients with an abnormal lupus band test.

In the proper setting, the results of a skin biopsy can directly influence the doctor's decision for optimal treatments.

 

 
 

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When the first baby laughed for the first time, its laugh broke into a thousand pieces, and they all went skipping about, and that was the beginning of fairies. 
Heidirenn

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 #13 
Thank you for the info.
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