What should I do about lupus erythematosus?

Written by Liu Li Ning
Rheumatology
Updated on October 20, 2024
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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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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 Zhang Lin
Rheumatology and Immunology Nephrology
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What are the symptoms of the early stage of lupus erythematosus?

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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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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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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Lupus is what disease?

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.