What causes lupus erythematosus?

Written by Li Jing
Rheumatology
Updated on April 28, 2025
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Firstly, systemic lupus erythematosus is a chronic, multi-systemic, systemic autoimmune disease that commonly occurs in women of childbearing age, more frequently seen in females, with a significantly higher incidence rate in females than in males. The cause is currently unclear, only indicating that experts believe it is related to environmental pollution, viral infections, hormone levels, genetics, etc., but there is no definitive evidence proving which factors it is related to, only stating that there are studies linking it to these factors. Its clinical manifestations also vary, with most cases having a gradual onset, characterized by recurrent erythema, even pustules, Raynaud's phenomenon, etc. A minority of patients may have a sudden onset, primarily presenting with major hematologic damage.

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Written by Zhang Lin
Rheumatology and Immunology Nephrology
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What should I do if I have a fever with lupus erythematosus?

When patients with lupus experience fever, the fundamental approach is the use of ample steroids or other immunosuppressive drugs for treatment, which generally can quickly normalize body temperature. However, some patients may also experience fever during steroid use, possibly due to the steroids reducing immune function and inducing a bacterial infection. At this point, it is necessary to find evidence of infection and promptly treat with adequate sensitive antibiotics. Then, there will certainly be questions about why patients with lupus who have a fever cannot use antibacterial drugs or antipyretics. This is because fever in lupus patients is often an important indicator of disease activity. During acute phases, the fever is typically high, not caused by external infections, thus antibacterial drugs are ineffective. Using antipyretics can temporarily normalize body temperature, but once the effect of the medication wears off, the high fever may recur. Patients with lupus should not casually use medications. If medication is needed, it should be used under the guidance of a doctor.

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Written by Zhang Lin
Rheumatology and Immunology Nephrology
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Can lupus be cured?

Lupus erythematosus currently has no cure in clinical practice. However, an early diagnosis and treatment can significantly prolong the life expectancy of patients. Compared to the past, with standardized and effective individualized treatments, the 5-year survival rate can reach 95%, and the 10-year survival rate can reach 84%. However, the cause of lupus erythematosus is unclear, and no method can completely cure the disease. It is important to emphasize that there are already some medications available clinically that can alleviate the symptoms, allowing patients to live normal lives and work normally. Additionally, it is crucial not to resort to desperate measures by seeking random treatments or believing in folk remedies and secret family recipes shared by others. Such actions can not only delay proper treatment and waste money but also worsen the condition due to unclear formulations.

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Written by Zhang Lin
Rheumatology and Immunology Nephrology
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Lupus is what disease?

Lupus erythematosus, also known as systemic lupus erythematosus, is a chronic autoimmune disease involving multiple systems and organs. Patients' serum contains various autoantibodies, with the main pathological changes being inflammatory reactions and vascular abnormalities. Most patients exhibit butterfly-shaped erythema on the bridge of the nose and cheeks, which is the most characteristic manifestation of lupus erythematosus. The clinical presentations of systemic lupus erythematosus are diverse, generally characterized by the "four multiples": involvement of multiple systems, multiple organs, multiple autoantibodies, and a higher prevalence among women of childbearing age. Without proper and effective treatment, the mortality rate is high, with the main causes of death being infections, renal failure, and damage to the central nervous system.

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Written by Liu Li Ning
Rheumatology
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What should I do about lupus erythematosus?

Lupus erythematosus requires early and formal treatment to stabilize the condition. For mild cutaneous lupus erythematosus, topical immunosuppressants, such as tacrolimus ointment, and immunomodulators, such as hydroxychloroquine, can be used. Low-dose corticosteroids may be necessary for combination therapy. Systemic lupus erythematosus generally requires corticosteroids as the basis of treatment, combined with one or several immunosuppressants to effectively control the disease. Systemic lupus erythematosus often involves multiple organs, with the kidneys, hematological system, and lungs being the most common. Therefore, it is necessary to use corticosteroids in combination with immunosuppressants to control the progression of the disease, as using only immunomodulators is often insufficient.

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Written by Zhang Lin
Rheumatology and Immunology Nephrology
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Can lupus be treated without steroids?

Hormones are currently the first choice of drugs for treating lupus erythematosus, and there are no other drugs that can replace them temporarily, so we still recommend using hormones for treatment. Hormones can quickly and effectively suppress the immune response, reducing the damage to the patient's body from the inflammatory substances released during the immune response. This kind of immune-suppressive and anti-inflammatory action is a protective therapeutic effect on the body. Although long-term use of large doses of hormones has certain side effects, it can quickly block the development of the disease and alleviate the condition. The function of hormones cannot be replaced by any other drug at present, so, no matter what stage the lupus erythematosus patients are in and regardless of the type of damage, hormones are the first choice of drugs. Hormones have many side effects, therefore, we need to use hormone drugs for treatment rationally and standardized under the guidance of a doctor, and should not take them arbitrarily to avoid serious consequences.