Lupus Erythematosus

Lupus Erythematosus

Lupus Erythematosus (LE) is a chronic disease that, if left untreated or undiagnosed, can be fatal. It is an “auto-immune” disorder which, because of recent medical advances, is becoming less fatal. LE causes the body’s immune system to attack the cells and tissue, resulting in inflammation and damage. It can affect any part of the body, but most often harms the lungs, joints, liver, heart, blood vessels, skin, nervous system and kidneys. Patients with LE often develop many different types of skin lesions.

There are 2 main categories of LE skin diseases:

  • LE-specific skin lesions - Those skin lesions that occur only in people with LE
  • LE-non-specific skin lesions - Those skin lesions that can occur in people with LE, but can also occur in other diseases

There are three main categories of LE-specific skin lesions:

  • Chronic Cutaneous LE (CCLE) in which the disease is limited to the skin
  • Subacute Cutaneous LE (SCLE)
  • Acute Cutaneous LE (ACLE)

It is difficult to predict the course of any form of LE. Patients usually experience periods of illness called flares alternating with remission. LE occurs at any age, and appears most frequently in non-European women. There is currently no cure. However, people with LE can lead long and substantial lives through treatment.

What does Lupus Erythematosus look like?

Many different skin rashes can occur with LE, including a red butterfly-shaped rash. This may spread out across the face stemming out from the bridge of the nose. A coin-shaped rash causes scaly, red bumps all over the body. The roof of the mouth may also develop irritated ulcers. Lupus patients tend to be very easily sunburned and commonly lose their hair.

How is Lupus Erythematosus diagnosed?

There is no single test to determine if a patient has LE. Usually, your doctor will ask you a series of questions, looking for common symptoms, and will perform blood tests. It is easier for your doctor to diagnose LE if you have the most common symptoms and if your blood contains anti-nuclear antibody (ANA) proteins. However, ANA testing and other antibodies form the mainstay of blood testing for LE.

How is Lupus Erythematosus treated?

Your doctor treats LE by dealing with its signs and symptoms. This includes preventing flare-ups and decreasing their severity during occurrences. There are many ways of preventing and dealing with flare-ups, including lifestyle changes, and medicines. Prednisone, which helps to suppress the body’s immune system, is used in combination with other “systemic” drugs. LE lesions can be treated with the application of corticosteroid creams, gels, ointments, solutions, and tapes. Oral antimalarial drugs like hydroxychloroquine are used with patients who have resistant or more widespread LE skin lesions.

Other oral drugs that are used include retinoids, prednisone, diaminodiphenylsulfone, gold, thalidomide, clofazimine, or immunosuppressive drugs like methotrexate, azathioprine, mycophenolate mofetil, or cyclosporine. Your physician will provide necessary information in choosing the right treatment and supervision, as well as proper selection and use of sunscreens.

In summary, LE is treated by:

  • Applying corticosteroid cream for skin lesions
  • Taking nonsteroidal anti-inflammatory drugs ( NSAIDs) for joint or muscle pain and fever
  • Taking antimalarial medicines to treat fatigue, joint pain, skin lesions, and lung inflammation
  • Taking low-dose corticosteroids if other medicines are not controlling your symptoms

How to prevent Lupus Erythematosus

People with LE should use sunscreens when exposed to direct sunlight. Prolonged periods of exposure, especially between the hours of 10 am and 4 pm, should be avoided, as well as exposure to fluorescent lights and artificial tanning salons. Tightly woven clothing and wide-brimmed hats should be worn as well. A broad-spectrum sunscreen or block (SPF30) with protection against UVA and UVB rays should be reapplied every 1 ½ to 2 hours.

The chances of developing LE are higher in people who:

  • Are female
  • Are black or Asian
  • Are between the ages 15 and 45
  • Have a family history of LE
  • Take medications that are associated with drug-induced systemic lupus