Will the rash of lupus fade away?

Written by Zhang Lin
Rheumatology and Immunology Nephrology
Updated on September 08, 2024
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Patients with lupus often experience recurrent, stubborn skin lesions on their hands or face, and some may even develop ulceration, atrophy, or scarring on top of the existing erythema. Most lupus patients exhibit erythema, centered around the bridge of the nose and appearing on the cheeks. The lesions are disc-like on both sides with generally clear boundaries, either flat or slightly raised, and are categorized as exudative inflammation. Depending on the severity of the inflammation, the erythema can range from light red, bright red to purple-red. In severe cases, localized edema resembling erysipelas may occur, and scaling and hyperpigmentation may appear as the inflammation subsides. Facial rashes generally resolve, and most rashes do not leave marks after resolution. If hyperpigmentation remains after the erythema has resolved, it suggests a good prognosis. However, erythema in other areas, such as acral erythema and reticular cyanosis, may last for varying durations depending on the patient's individual condition.

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Written by Zhang Lin
Rheumatology and Immunology Nephrology
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What should I do if lupus causes hair loss?

What should be done when a lupus patient experiences hair loss? Patients with lupus should keep their hair clean in daily life, not use too much shampoo when washing their hair, avoid dyeing or perming their hair, and reduce the damage to hair from chemical products. This prevents rashes or worsening rashes caused by allergies to hair dyes and damage to hair quality from perming. If hair loss occurs due to the effect of medications, patients can choose to wear a wig during treatment. After chemotherapy ends, new hair will grow, so patients need not worry excessively. Maintaining a pleasant mood is also quite important for recovery from the disease. The basic pathological change in lupus patients is vasculitis. When the small blood vessels in the skin become inflamed, the nutrient supply to the hair follicles is disrupted, which can easily lead to hair loss and affect hair growth. Generally, hair can regrow after the disease is controlled. If hair loss occurs again, it could be a symptom of a disease relapse.

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Written by Zhang Lin
Rheumatology and Immunology Nephrology
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Can lupus patients get pregnant?

Patients with lupus can conceive normally, but it is not recommended to become pregnant. This is because patients with lupus who become pregnant are prone to miscarriage, preterm birth, stillbirth, and poor fetal development in the uterus, especially in patients who are positive for antiphospholipid antibodies. Pregnancy can also aggravate the disease or cause a relapse in lupus patients, and even if the disease is stable, there are cases where the condition worsens during pregnancy or after childbirth. Therefore, it is not recommended for patients with active systemic lupus erythematosus to become pregnant. If the condition has been stable for more than a year after treatment and the patient has been off medication for at least 6 months, then pregnancy can be considered. However, it is important to note that dexamethasone, immunosuppressants, and Tripterygium wilfordii tablets have side effects on the fetus and should be avoided.

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Written by Liu Li Ning
Rheumatology
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What is lupus and is it serious?

Lupus erythematosus is an autoimmune disease, which can be very severe in some cases and mild in others. For example, cutaneous lupus erythematosus generally does not involve major organs and usually presents with mild symptoms, primarily affecting the skin and mucous membranes. However, systemic lupus erythematosus can affect significant organs like the kidneys and heart in many patients, often leading to severe medical conditions. Especially, patients with rapidly progressive glomerulonephritis and those with coronary atherosclerotic heart disease tend to have a higher mortality rate. If systemic lupus erythematosus is diagnosed, it is crucial to receive standardized treatment early. Typically, treatment involves long-term maintenance with corticosteroids and immunosuppressants to control the progression of the disease and reduce the likelihood of mortality.

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Written by Zhang Lin
Rheumatology and Immunology Nephrology
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How is lupus treated?

The treatment of lupus erythematosus mainly involves the following aspects: Firstly, mild patients can be treated with antimalarial drugs, such as chloroquine or hydroxychloroquine, thalidomide, and low-dose corticosteroids; moderate active patients can receive individualized treatment with corticosteroids, and immunosuppressants may be used when necessary; for severe patients, corticosteroids are the preferred treatment, combined with immunosuppressants such as cyclophosphamide. Secondly, for lupus crisis patients, treatment can involve immunoglobulin, high-dose corticosteroid pulse therapy. Thirdly, biologics, such as anti-CD20 monoclonal antibodies, plasmapheresis, and autologous stem cell transplantation, are also used clinically. Medication for treating lupus erythematosus should be used under the guidance of a doctor, and self-medication should be avoided to prevent serious consequences.

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Written by Zhang Lin
Rheumatology and Immunology Nephrology
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What should I do about lupus joint pain?

In patients with systemic lupus erythematosus, most suffer from arthralgia. The joint pain caused by systemic lupus erythematosus is due to the deposition of immune complexes in the joint cavity, or inflammation of the blood vessels nourishing the joints. This primarily manifests as joint swelling and pain, and often occurs symmetrically. When joint pain occurs in lupus, in addition to corticosteroid therapy, we can also use non-steroidal anti-inflammatory drugs (NSAIDs) under the guidance of a doctor. These drugs can achieve good analgesic and anti-inflammatory effects. However, patients with renal insufficiency should use these drugs with caution.