Will the rash of lupus fade away?

Written by Zhang Lin
Rheumatology and Immunology Nephrology
Updated on September 08, 2024
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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 Liu Li Ning
Rheumatology
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How long will the skin itch in the early stages of lupus erythematosus?

The duration of itching in the early stages of lupus erythematosus is not fixed. It is not certain that early-stage lupus erythematosus will cause itching. Some patients may experience itching, which can subside on its own, but it tends to recur. Additionally, some patients may have itching due to allergies, which can result in rashes accompanied by itching. It is possible to check immunoglobulin E to see if there are any allergic factors present. If allergies are involved, treatment can include antihistamines or corticosteroids, or topical calamine lotion can be used to relieve symptoms. Besides affecting the skin, early-stage lupus erythematosus can also cause symptoms such as oral ulcers and arthritis in many patients.

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Written by Liu Li Ning
Rheumatology
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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.

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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.

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Written by Zhang Lin
Rheumatology and Immunology Nephrology
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How is lupus treated?

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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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.