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Liu Li Ning
Rheumatology
About me
Graduated from Tongji Hospital affiliated to Tongji Medical College of Huazhong University of Science and Technology, with a Master's degree. Specializes in various rheumatic diseases, especially proficient in dealing with complex rheumatic conditions.
Proficient in diseases
Rheumatoid arthritis, ankylosing spondylitis, systemic lupus erythematosus, Behçet's disease, Sjögren's syndrome, scleroderma, osteoarthritis, etc.
Voices
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.
Where does lupus erythematosus generally appear?
Lupus erythematosus can appear on various parts of the body. The most typical rash is the butterfly rash on the face, but it can also appear on other parts, such as discoid lupus, annular erythema, periungual erythema, and livedo reticularis. Additionally, systemic lupus erythematosus affects not only the skin and mucosa but can also involve the lungs, kidneys, heart, central nervous system, and other systems. Common manifestations include lupus nephritis and lupus pneumonia. The precise pathogenesis of systemic lupus erythematosus is still unclear. If the damage is confined to the skin and mucosa, immunomodulators such as hydroxychloroquine can be used for treatment. If important organs are involved, it generally requires long-term maintenance treatment with corticosteroids combined with immunosuppressants to control the progression of the disease.
Rheumatoid arthritis hurts more at night or during the day?
The pain of rheumatoid arthritis is irregular. It can hurt at night or during the day, and it varies from person to person. The onset of rheumatoid arthritis is somewhat related to streptococcal infection. Clinically, it mainly presents as migratory swelling and pain in the large joints of the limbs, generally without leaving joint deformities. The onset of rheumatoid arthritis is related to streptococcal infection, so it requires treatment with penicillin antibiotics. During the acute phase, it is also recommended to use non-steroidal anti-inflammatory drugs to alleviate symptoms. Commonly used drugs include sustained-release capsules of diclofenac sodium, meloxicam, or etoricoxib.
Can you drink alcohol with rheumatic fever?
Rheumatic fever should not involve alcohol consumption. Because drinking could potentially trigger a flare-up of rheumatic fever and worsen the symptoms. Rheumatic fever is an inflammatory disease caused by Group A beta-hemolytic streptococcal infection. Common clinical manifestations include fever, subcutaneous nodules, erythema marginatum, joint pain or arthritis, chorea, carditis, and so forth. During the acute phase, the main symptoms are fever and joint pain, which can be treated with penicillin antibiotics to combat infection. Joint pain can be relieved with non-steroidal anti-inflammatory drugs, such as etoricoxib. In cases where carditis occurs during the acute phase, combined treatment with corticosteroids is also required. Regarding diet, it is advisable to eat lightly, and both smoking and drinking alcohol should be avoided.
Can women with lupus erythematosus have sexual intercourse?
Women with lupus can engage in sexual activity. Sexual activity itself does not affect systemic lupus erythematosus, but it is essential to use contraception. It is recommended to use condoms for contraception. The use of contraceptive pills or withdrawal method is generally not recommended. This is because, in case of an unplanned pregnancy, there could be a risk of triggering a flare-up of the disease. Moreover, the risk of miscarriage or embryonic developmental arrest in pregnant women with lupus is much higher than in healthy individuals. If there are plans for pregnancy, it should only be considered after the disease has been stable for more than six months. During pregnancy, it is crucial to follow medical advice strictly regarding medication and to regularly undergo prenatal screening.
How to quickly relieve rheumatic fever pain?
Rheumatic fever pain can be treated with non-steroidal anti-inflammatory drugs (NSAIDs) for rapid pain relief. NSAIDs are the first-line medications for treating rheumatic fever pain. Commonly used ones include diclofenac sodium sustained-release capsules, etoricoxib, meloxicam, or etodolac. These medications may cause gastrointestinal discomfort, so they cannot be used by patients with active peptic ulcers. If there are contraindications to using NSAIDs, pain relief can be achieved with medications such as tramadol or Aconitum alkaloid tablets. If rheumatic fever is accompanied by carditis, treatment with corticosteroids is also necessary. Since the onset of rheumatic fever is related to streptococcal infections, the use of penicillin antibiotics for anti-infection treatment is also recommended.
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.
How should rheumatoid arthritis be treated?
The treatment of rheumatoid arthritis includes several aspects. First, general treatment: keep a light diet, avoid spicy and stimulant foods, ensure joints are kept warm, and avoid excessive fatigue. Second, medication treatment: during acute flare-ups, non-steroidal anti-inflammatory drugs such as diclofenac sodium or etoricoxib can be used, possibly combined with low doses of corticosteroids. During stable phases, immunosuppressants such as methotrexate or leflunomide are needed. If conventional treatments are ineffective, biological agents like adalimumab or tofacitinib can be combined. Most patients can effectively control their condition after combined treatment. Third, traditional Chinese medicine: alongside Western medicine, Chinese herbal medicine such as total glucosides of paeony or tripterygium wilfordii polyglycoside can be used.
What does the early rash of lupus look like?
The early characteristic rash of lupus erythematosus is typically a butterfly-shaped rash on the face. Other common presentations include palm and periungual erythema, discoid rash, nodular erythema, and livedo reticularis. If the rash is not notably itchy, it generally indicates lupus erythematosus. If there is significant itching, it may suggest the possibility of an allergic factor active in the disease. After immunosuppression, itchy rashes should be monitored for possible fungal infections. The specific pathogenesis of systemic lupus erythematosus is still unclear. If a patient exhibits the typical butterfly-shaped rash on the face, systemic lupus erythematosus should be highly suspected. Testing for antinuclear antibodies, and specifically for anti-Sm and double-stranded DNA antibodies, which represent a variety of autoantibodies, can diagnose systemic lupus erythematosus.
Can rheumatoid arthritis be cured through exercise?
Rheumatoid arthritis can be somewhat alleviated by exercise in terms of disease recovery. Rheumatoid arthritis primarily manifests as migratory swelling and pain in the major joints throughout the body. The onset of the disease is somewhat associated with streptococcal infections. In recent years, due to the widespread use of penicillin, rheumatoid arthritis has become very rare in clinical settings. Since the onset of rheumatoid arthritis is related to infections, long-acting penicillin is generally used for treatment if there is no accompanying carditis. Joint pain can be treated with non-steroidal anti-inflammatory drugs such as etoricoxib or sustained-release capsules of diclofenac sodium; if carditis is present, corticosteroids can be used. Patients with rheumatoid arthritis can engage in gentle aerobic exercises like swimming, yoga, jogging, Tai Chi, etc.