How is lupus treated?

Written by Zhang Lin
Rheumatology and Immunology Nephrology
Updated on September 09, 2024
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The treatment of lupus erythematosus mainly involves the following aspects: Firstly, mild patients can be treated with antimalarial drugs, such as chloroquine or hydroxychloroquine, thalidomide, and low-dose corticosteroids; moderate active patients can receive individualized treatment with corticosteroids, and immunosuppressants may be used when necessary; for severe patients, corticosteroids are the preferred treatment, combined with immunosuppressants such as cyclophosphamide. Secondly, for lupus crisis patients, treatment can involve immunoglobulin, high-dose corticosteroid pulse therapy. Thirdly, biologics, such as anti-CD20 monoclonal antibodies, plasmapheresis, and autologous stem cell transplantation, are also used clinically. Medication for treating lupus erythematosus should be used under the guidance of a doctor, and self-medication should be avoided to prevent serious consequences.

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Written by Zhang Lin
Rheumatology and Immunology Nephrology
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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.

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Written by Zhang Lin
Rheumatology and Immunology Nephrology
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What should I do if lupus causes hair loss?

What should be done when a lupus patient experiences hair loss? Patients with lupus should keep their hair clean in daily life, not use too much shampoo when washing their hair, avoid dyeing or perming their hair, and reduce the damage to hair from chemical products. This prevents rashes or worsening rashes caused by allergies to hair dyes and damage to hair quality from perming. If hair loss occurs due to the effect of medications, patients can choose to wear a wig during treatment. After chemotherapy ends, new hair will grow, so patients need not worry excessively. Maintaining a pleasant mood is also quite important for recovery from the disease. The basic pathological change in lupus patients is vasculitis. When the small blood vessels in the skin become inflamed, the nutrient supply to the hair follicles is disrupted, which can easily lead to hair loss and affect hair growth. Generally, hair can regrow after the disease is controlled. If hair loss occurs again, it could be a symptom of a disease relapse.

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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 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.

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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.