Lupus is what disease?

Written by Zhang Lin
Rheumatology and Immunology Nephrology
Updated on September 12, 2024
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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 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.

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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.

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Written by Zhang Lin
Rheumatology and Immunology Nephrology
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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.

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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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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.