Skin Lupus and Scleroderma

This information is useful for children and adults
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Why Yale Medicine?
  • Our services offer hope for patients with resistant dermatologic illnesses affecting the skin.
  • The Department of Dermatology at Yale Medicine is deeply rooted in research.
  • We offer an interdisciplinary approach to patient care.

People with autoimmune diseases often face a complicated journey to diagnosis and treatment. Those whose skin is affected face the additional stigma of having symptoms that are visible to everyone they meet. 

Doctors in Yale Medicine's dermatology and rheumatology departments work closely together to help people with autoimmune diseases such as lupus and scleroderma look and feel as good as possible. They not only provide warm, personal patient care, but also participate in research to advance treatment of skin conditions associated with autoimmune diseases for people all around the world.

Autoimmune diseases tend to bring complicated symptoms. Many people with these conditions see doctors in several medical specialties. Lupus and scleroderma are two that primarily affect the skin, requiring dermatology care. But these diseases may also affect connective tissues, which are treated by a rheumatologist. “At Yale Medicine, we aim for an interdisciplinary approach for patients who may require the expertise of multiple specialists,” says Sarika Manoj Ramachandran, MD, a Yale Medicine dermatologist and assistant professor of dermatology at Yale School of Medicine.

When a person’s immune system starts fighting against the cells it’s supposed to protect, it can lead to autoimmune diseases, several of which affect the skin and internal organs. In most of these skin-involved diseases, symptoms can vary greatly from person to person. (For example, not all patients with one of these autoimmune diseases will eventually have symptoms that affect internal organs.) Two of the most common such conditions are lupus and scleroderma. 

  • Lupus: A disease called lupus leads to a wide variety of symptoms, many of which can resemble other skin diseases. When it affects the skin, the condition is known as cutaneous lupus (or skin lupus). It can come in many form —most commonly, patients will see a butterfly-shaped rash, often on the face. When it spreads beyond the skin, it’s known as systemic lupus erythematosus (SLE), and the inflammation can affect the joints, the kidneys and other organs.
  • Scleroderma: Like lupus, scleroderma can affect the skin, or it can become systemic. In this case, the immune system produces too much collagen, causing the skin to tighten and become tough and hard. When scleroderma is localized, or mainly affecting the skin, it can either be morphea, which manifests as oval patches, or linear, which shows up as streaks of hard patches. When scleroderma is systemic, it can develop slowly or quickly, affecting internal organs such as the lungs, heart and kidneys.