A warm welcome to the forum Pilipala
I wouldn't hesitate to have a skin biopsy to help determine if I have lupus and just as important if I should take Plaquenil or not. Plaquenil takes several months to work and while it is described as a benign drug there is not much point taking any medicine if it is not the right one. It will only delay diagnosis further.
That being said, the biopsy doesn't always reveal lupus but if it is negative it doesn't mean you don't have lupus. If it does show lupus that is a major step and there is no doubt whatsoever that Plaquenil is appropriate.
It is important that the biopsy be examined by a specialist dermatopathologist, if at all possible. In the USA this means a board certified dermatopathologist. In the UK we might just have to take our chances depending on where we are being treated, but it is important that the pathologist knows what he is looking for.
The chances are reasonably high that the biopsy will show lupus. Most often with SLE the biopsy is taken from a partially exposed but non affected area such as the innner forearam and/ or from non exposed non affected area such as a buttock where a tiny scar wouldn't bother most people.
I have never heard of anybody having having any complications during or after the biopsy. It doesn't hurt and a few days with a stitch or two isn't all that hard to bear.
I have had three wedge or slice biopsies over the years but none recently. One was from my inner forearm and the other two from lesional skin, under my chin and the last on the 'vee' of the chest where I had a lupus lesion.
That was over 15 years ago and I admit there is a noticeably white + shaped scar there about an inch across and half an inch wide. It would certainly bother me except that it is the least of my appearance concerns and my total appearance has to be the least of my many other concerns in life. That is by the way an unusual place to take a biopsy but if by any chance the doctor should propose to take it from somewhere where it might be visible ask him not to - there are options.
However the biopsy most often used is the punch biopsy where a tiny plug is removed. I don't know how how that scars.
I can't see the other two biopsy marks at all but my skin is very white and I have no particular problems with scarring, no keloid concerns for example.
Debilitating fatigue is the major complaint in lupus but there are several possible reasons for it apart including diseases that are often enough found with lupus. Anemias of various sorts including B12 deficiency should be carefully looked for. A disease called fibromyalgia which has many symptoms similar to lupus, diabetes and thyroid are other possibilities.
Of course fatigue is very common in young conscientious mothers even when the children have no particular problems and they are stay at home mums. As a general remark, the tendency is to soldier on and not acknowledge how tough things are, thus not looking for all ways to make life easier.
Please ask any questions you might have and we'll do our best to help you.
Bye for now
Clare
