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Lupus Erythematosus
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.
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.
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.
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.
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.
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.
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.
What are the symptoms of a lupus flare-up?
After treatment with steroids and other therapies, active lupus erythematosus usually improves and enters a stable phase. However, factors such as infection, pregnancy, surgery, fatigue, and discontinuation of medication can trigger the transition from a stable phase back to an active phase of lupus erythematosus. The following symptoms should be considered for a possible recurrence of the disease: First, onset of fever without reasons related to colds or infections. Second, appearance of new rashes or vascular-like rashes on fingertips and other areas. Third, recurrence of joint swelling and pain. Fourth, significant hair loss. Fifth, development of fresh ulcers in the mouth or nose. Sixth, development of fluid accumulation in the chest cavity or pericardium. Seventh, increased protein in urine, decrease in white blood cells or platelets, or significant anemia.
Can lupus be inherited?
Lupus erythematosus is not a genetic disease, but it is a disease with a genetic predisposition. This means that genetic diseases refer to monogenic diseases, including albinism, color blindness, etc., which are determined by a pair of alleles. However, lupus erythematosus is a disease with a genetic predisposition, determined by multiple genes. Although lupus erythematosus is not a genetic disease, if your parents have lupus erythematosus, the chance of the next generation developing lupus erythematosus is about 1% to 16%. This relationship is especially significant between mothers and daughters, and among sisters. Genetic factors account for approximately 20% of the importance in the development of lupus erythematosus. Only the combination of genetic factors and environmental factors together can lead to the occurrence of lupus erythematosus.
Does lupus cause itchy skin?
The rash in patients with lupus erythematosus is generally not noticeably itchy. In patients with lupus erythematosus, the characteristic changes include a butterfly-shaped rash on the bridge of the nose and cheeks. The skin lesions of lupus erythematosus include photosensitivity, hair loss, erythema on the palms and soles and around the nails, discoid lupus, nodular erythematosus, seborrheic dermatitis, livedo reticularis, and Raynaud's phenomenon, among others. Generally, there is no noticeable itching. If significant itching occurs, it suggests an allergy. Itchy rash after immunosuppressive treatment should be monitored for fungal infections. Lupus patients receiving steroid and immunosuppressive therapy, if experiencing unexplained localized skin burning, may be showing early signs of herpes zoster and should seek prompt medical attention at a hospital.