What should I do about lupus erythematosus?

Written by Liu Li Ning
Rheumatology
Updated on October 20, 2024
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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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Symptoms of childhood lupus

Childhood systemic lupus erythematosus generally presents similarly to adults. It is a relatively common systemic autoimmune disease, more commonly seen in girls than boys. It involves multiple autoantibodies primarily including antinuclear antibodies and widespread small arteriole pathology, affecting multiple systems. Clinically, it can manifest with fever, skin lesions, such as butterfly rash on the face, as well as damage to the joints, kidneys, liver, heart, serous membranes, and a reduction in all blood cells. Generally, the ratio of females to males ranges from about 6:1 to 9:1. The prognosis of this disease is generally poor.

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Will the rash of lupus fade away?

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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Does lupus erythematosus transmit through living and eating together?

Lupus erythematosus is not contagious through sharing meals or living together. It is an autoimmune disease, not an infectious one, hence it cannot be transmitted to others by living or eating together. The exact mechanism of lupus is currently unclear, but it may be related to various factors such as sex hormones, genetics, infections, and physical and chemical factors, and it is more commonly seen in females. Clinically common symptoms include fever, rash, joint pain, oral ulcers, hair loss, etc. The clinical manifestations vary depending on the affected target organ. If lupus nephritis occurs, symptoms such as edema can appear. If the lungs are involved, it can promote pulmonary interstitial fibrosis, and in severe cases, patients may experience chest tightness, shortness of breath, and breathing difficulties.

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Do the rashes caused by lupus itch?

The erythema triggered by lupus erythematosus may or may not be itchy, varying from person to person, with each individual's condition not being entirely the same. The erythema caused by systemic lupus erythematosus also presents very differently clinically, with the typical manifestation being a butterfly-shaped erythema on the face. Other common forms include discoid erythema, reticular purpura, polymorphic rash, periungual erythema, and more. The specific pathogenic mechanism is currently unclear, and in some patients, the condition is caused by photosensitivity. After treatment, the erythema cannot completely disappear in a significant number of patients, leaving some pigment deposition. If only the skin is affected, treatment can involve the topical use of tacrolimus ointment or the oral intake of immunomodulators like hydroxychloroquine, and if necessary, oral corticosteroids may be administered.

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Lupus erythematosus taking steroids side effects

Patients with lupus mainly use steroid treatment, but steroids have many side effects during their application, such as increased blood pressure, inducing or exacerbating infections, inducing or aggravating peptic ulcers, necrosis of the femoral head, osteoporosis and vertebral compressive fractures, delaying wound healing in injured patients, increasing blood sugar, etc. Additionally, steroids can cause nervous sensitivity, agitation, insomnia, emotional changes, and even apparent mental symptoms, inducing seizures such as epilepsy. Some patients may also have suicidal tendencies. Therefore, it is necessary to use medication rationally under the guidance of a doctor, reduce the dosage timely, and effectively prevent and treat to minimize the occurrence of side effects. Taking steroids can also lead to weight gain; hair loss is relatively less common. The occurrence of side effects varies among individuals and should be tailored to the patient's specific condition.