With really fair skin, I've always expected that one day I'll have skin cancer, so I've tried to pay attention to various spots and sores. A couple years ago after a rash and some sores that weren't healing, my dermatologist tested a sample, told me I have skin lupus, wrote me a prescription, and told me to avoid the sun. That didn't sound exactly good, but hey it wasn't cancer, so I put my worries aside. No way I was going to stop hiking.

Since then I've used the prescription (Plaquenil) very little, pretty much just when I'd been outside a lot and had developed a rash.

Beginning around Jan 1st I'm experiencing my first lupus flare: sore, stiff, swollen joints in my hands and wrists at first, now in my shoulders. Had a visit this morning with a new doctor (primary care - to get a rheumatologist referral). Current symptoms + online research + doctor visit = more obedient patient. I will take my medicine. I will follow through with associated monitoring for side effects. I will avoid excessive sun exposure, which can trigger a flareup. But I won't stop hiking (doctor did not discourage hiking).

I'm sure I'm not the only one advised to stay out of the sun. Sunscreen is laughable for me, washed off in sweat within a short while. A wide-brimmed hat is okay, but only works for the shaded areas and when the sun is high. I've used an umbrella where trail conditions merit the extra weight. Unless it's frigid, I usually hike in shorts and short sleeves. Is it better to die slowly from lupus, or quickly from heat stroke? For others with similar issues, how do you handle it?