Systemic Lupus Erythematosus

Systemic Lupus Erythematosus is an autoimmune connective tissue disease.

The disease caused damages to many organs and tissues, mainly the skin, but also joints, kidneys and others. The course of the disease is usually mild , but there are also life- threatening cases. The disease can mainly affect the skin, but skin lesions might also be the part of internal organ changes.

Symptoms

The first symptoms of Systemic Lupus Erythematosus are very non- specific, which can also occur in other diseases.

The very first symptoms are: general tiredness, lack of appetite, subfebrile states and fever.

Systemic Lupus Erythematosus manifests as characteristic butterfly-shaped erythema on the face that appears after sun exposure.

 This redness most often involves skin on the cheeks and dorsum on the nose, but can also be seen on the forehead, neck and deckline. In active form of the disease might also occur (usually painless) erosions of the mucous membranes of the mouth and nose.

More characteristic symptoms, occur later are migratory joint pains.

The most common are pains in the wrists, knees and fingers and toes.

Wandering muscle pain of varying severity from one place to another is also characteristic. This is often the reason for taking certain medications or the result of muscle inflammation. Muscle atrophy is also a common result of lupus, which is evident in the form of weakness and decreased physical performance.

Causes and risk factors

 We don’t know the exact cause of lupus, but it is certainly related to genetic predisposition and the action of external stimuli such as:

• Exposure to light – the immune system of a person with lupus cannot cope with the removal of epidermal cells damaged by ultraviolet rays. The immune system attacks its own cells, resulting in inflammation and visible characteristic skin

changes

• Infection
• Sex hormones – the incidence of lupus has been linked to oestrogen and prolactin levels, which explains why women get the disease much more often. Hormone replacement therapy and oral contraceptives may also cause a greater risk of lupus and exacerbation of the disease
• Diet and lifestyle – high-fat diet, smoking can stimulate the development of autoimmune diseases, including lupus.

Diagnosis and treatment

If you have facial erythema and urticaria on your skin after exposure to sunlight, erosions of the mucous membranes of the mouth and nose, and feel general weakness, wandering joint pain, you should immediately see a doctor for appropriate diagnosis and treatment.

The most common diagnosis of lupus includes blood serum tests to detect specific antibodies, and X-ray to rule out other diseases. For diagnostic purposes, the ACR (American College of Rheumatology) classification criteria are used.

Treatment of lupus is tailored depending on the symptoms present. Avoiding excessive exposure to sunlight, limiting exercise and stress, supplementation with vitamin D and folic acid are often recommended.

Currently, a cure for lupus erythematosus is impossible due to the variety of symptoms and varying severity of the disease. However, with personalised treatment, complete or partial remission of symptoms is possible. For cutaneous variants of lupus erythematosus, the most effective methods are topical therapy and photoprotection. In the absence of improvement, the doctor decides on additional systemic treatment such as antimalarials. Intensive research is currently underway to find an effective drug for lupus.