What are the symptoms of the early stage of lupus erythematosus?

Written by Zhang Lin
Rheumatology and Immunology Nephrology
Updated on September 15, 2024
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The main symptom in the early stage of lupus is the appearance of a butterfly-shaped rash on the face, with most patients initially exhibiting these rashes, some of which are not butterfly-shaped. The rash can also appear on fingers, palms, and around the nails. Additionally, over 80% of patients experience unexplained fevers, which are irregular and can sometimes reach up to 40 degrees Celsius. Some patients also experience joint pain in the early stages of the disease, mainly starting with pain in larger joints such as the elbows, knees, and ankles. If joint pain is accompanied by fever, rash, and a decrease in white blood cells, it is advisable to promptly visit a hospital for an examination to check for lupus. Some patients may also experience Raynaud's phenomenon and photosensitivity in the early stages of lupus. There are no fixed symptoms in the early stages of lupus; it is mainly important to observe oneself regularly and seek medical attention if feeling unwell.

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Written by Zhang Lin
Rheumatology and Immunology Nephrology
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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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Written by Zhang Lin
Rheumatology and Immunology Nephrology
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What causes lupus erythematosus?

The cause of lupus erythematosus is not yet very clear. It is generally believed that the disease is caused by a combination of factors including genetics, environment, estrogen levels, and drugs, leading to immune disorder and consequently the onset of this disease. Studies have found that factors directly related to the onset of lupus erythematosus include ultraviolet rays causing apoptosis of epidermal cells, exposure of new antigens becoming autoantigens, and infections; Other possible related factors include drugs such as hydralazine and isoniazid, as well as food dyes, hair dyes, celery, figs, mushrooms, smoked foods, psychological stress, etc.; it may also be related to factors such as tobacco, vinyl chloride, asbestos, and vaccinations.

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Written by Liu Li Ning
Rheumatology
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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.

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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 foods are good for lupus erythematosus?

The diet for patients with lupus erythematosus varies from person to person. Generally, the ideal food for lupus patients should have the following characteristics: an appropriate amount of high-quality protein, low fat, low salt, low sugar, and rich in vitamins and calcium. Since many lupus patients often have significant kidney damage, proteins are frequently lost in large amounts through the urine, causing hypoalbuminemia and edema. The supplementation of protein should primarily consist of high-quality animal proteins, such as milk, eggs, and lean meats. However, protein intake should also be appropriate and not excessive. Excessive intake can not only lead to incomplete absorption by the patient, increasing the burden on the gastrointestinal tract, but also increase the excretion of nitrogenous compounds in the body, further burdening the kidneys. Lupus patients should avoid or minimize consumption of foods that can enhance photosensitivity, such as figs, rapeseed, cilantro, and celery. If consumed, they should avoid sun exposure afterwards. Mushrooms, smoked foods, and certain food dyes can also trigger lupus and should be avoided or minimized in the diet.