In autoimmune diseases, the immune system mistakenly attacks the body’s own tissues. Many of these conditions show up first on the skin, hair or nails, so a dermatologist is often the first specialist to recognize them. At North Dallas Dermatology Associates, our board-certified dermatologists diagnose and treat autoimmune skin diseases as part of our medical dermatology practice, serving North Dallas, Preston Hollow, Highland Park, University Park, Lake Highlands, White Rock and Richardson.
Most of these conditions can’t be cured, but they can often be controlled. Because some also affect the joints or internal organs, your care may involve other specialists, such as a rheumatologist.
How Autoimmune Skin Diseases Are Diagnosed
Diagnosis usually starts with a careful look at your skin and your medical history. Depending on what your dermatologist sees, you may need a skin biopsy, blood tests or both. Many of these conditions can look alike, so testing helps confirm the right diagnosis before treatment starts.
Autoimmune Conditions We Treat
Alopecia Areata
Alopecia areata happens when the immune system attacks hair follicles, causing hair loss in round patches on the scalp, beard or body. In some people it is more extensive. The course is hard to predict: hair may regrow on its own, fall out again, or, less commonly, be lost over the whole scalp or body. People with alopecia areata are generally otherwise healthy, but hair loss can be very distressing.
Treatment aims to help hair regrow and may include steroid injections into the patches, prescription creams and, for severe cases, newer oral medications called JAK inhibitors. Your dermatologist will discuss which options fit your situation.
Bullous Pemphigoid and Pemphigus
Bullous pemphigoid (BP) is an autoimmune blistering disease that causes itchy, tense blisters, often on the arms, legs and trunk. It is most common in older adults. Pemphigus is a related but different condition that causes fragile blisters that break easily, leaving painful sores. Pemphigus often affects the mouth.
Both are confirmed with a skin biopsy and sometimes blood tests. Treatment may include strong topical or oral corticosteroids, anti-inflammatory medications and other immune-suppressing treatments. Many patients reach remission with treatment, although flares can happen, so regular follow-up is important.
Dermatomyositis
Dermatomyositis is a rare inflammatory disease that affects the skin and muscles. It can cause a purple-red rash on the eyelids, face, knuckles, elbows, knees, chest or back, along with muscle weakness, often in the hips, thighs, shoulders and upper arms. The rash can get worse with sun exposure.
In adults, dermatomyositis has been linked to a higher risk of some cancers, so your doctors may recommend cancer screening after diagnosis. Treatment often includes corticosteroids and other immune-suppressing medications, strict sun protection and, when needed, physical therapy, coordinated with other specialists.
Lupus
Lupus can affect the skin alone (cutaneous lupus) or many parts of the body, including the joints, kidneys, blood and other organs (systemic lupus). Skin signs can include a butterfly-shaped rash across the cheeks and nose, scaly round patches that may scar, and rashes after sun exposure. Not everyone with lupus has a rash.
There is no cure, but symptoms can be managed. Treatment may include sun protection, topical medicines, antimalarial medications and other immune-modulating treatments. Because lupus can affect internal organs, your dermatologist may order blood tests and work alongside your other doctors.
Scleroderma and Morphea
Scleroderma causes the body to make too much collagen, leading to hard, tight, thickened skin. Morphea is a form that affects only the skin, usually as firm, discolored patches. Systemic sclerosis can also affect internal organs. An early sign is often Raynaud’s phenomenon, in which the fingers turn white, then blue, then red in the cold.
Diagnosis is based on your history, an exam, blood tests and sometimes a biopsy. Treatment depends on the type and aims to slow skin changes and relieve symptoms, often with input from other specialists.
Vasculitis
Vasculitis means inflammation of the blood vessels. On the skin it often appears as small, raised purple-red spots, usually on the lower legs, and sometimes as hives, ulcers or sores. Some types affect only the skin, while others also involve the kidneys, joints, nerves or other organs.
Your dermatologist may recommend a biopsy, blood tests and a urine test to understand the type and whether other organs are affected. Treatment depends on the cause and may include treating an underlying trigger, such as an infection or medication, along with anti-inflammatory or immune-suppressing medicines.
Vitiligo
In vitiligo, the immune system attacks melanocytes, the cells that give skin its color, causing white patches. Patches often appear on the face, especially around the eyes and mouth, as well as the hands, feet, armpits and groin. Vitiligo is not contagious and is not harmful to your physical health, but it can strongly affect how people feel about their appearance.
Treatment aims to stop new patches and restore color. Options may include prescription creams, including a newer non-steroid cream, light therapy and, in some cases, oral medications. Results vary from person to person and often take months. Your dermatologist will help you choose the approach that fits your goals.
Psoriasis
Psoriasis is also an immune-mediated skin condition. Learn more on our eczema and psoriasis page.
Frequently Asked Questions
Many autoimmune diseases first appear on the skin, hair or nails. A dermatologist can recognize these signs, perform a skin biopsy when needed, and treat the skin symptoms, working alongside your other doctors when the condition affects other parts of the body.
No. Autoimmune diseases are caused by the immune system, not by an infection, and cannot be spread to other people.
Most can’t be cured, but many can be well controlled with treatment, and some go into remission. Your dermatologist will explain what to expect for your specific condition.
Not always, but a skin biopsy is often the most reliable way to confirm an autoimmune skin disease, because many of these conditions look alike. The area is numbed first, and the sample is sent to a lab.
To have a rash, blistering, hair loss or skin change evaluated, schedule an appointment or call (214) 420-7070. Meet our board-certified dermatologists and see our accepted insurance plans.
