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LUPUS


D E S C R I P T I O N
There are two forms of lupus: systemic lupus erythematosus (SLE) and discoid lupus erythematosus (DLE). SLE is an autoimmune disorder. SLE and DLE can share the sign of a facial rash, which sometimes causes confusion in diagnosis, but that's about the only thing they have in common. As their names indicate, SLE is a systemic disease, affecting many systems of the body, while DLE causes only the discoid, or round, skin lesions, which are usually confined to the face. It's not clear what causes either condition.


R I S K
Ninety percent of lupus cases occur in women, especially those between the ages of 15 and 55. SLE is about three times more common in African-American women than it is in those of European ancestry. Women of Chinese heritage are also commonly affected. Having another autoimmune condition puts one at a greater risk for SLE.


S Y M P T O M S
Approximately half of SLE patients have a scaly, red facial rash, the classic "butterfly rash," named for its shape across the cheeks and bridge of the nose. A facial rash with discoid lesions is the extent of DLE's symptoms. SLE patients may have rashes on many other parts of the body as well as arthritis; fatigue; hair loss; swollen lymph glands; kidney, lung, or heart problems and sensitivity to light, among other symptoms. Rashes in both SLE and DLE may flare up or fade away at various intervals.


T R E A T M E N T
DLE patients should wear hats to protect against the sun and use a good sunscreen. A doctor may prescribe a corticosteroid cream. In severe, exceptional cases a drug called hydroxychloroquine may be used; this medication may sometimes cause side effects of visual impairment and nausea.

SLE is treated symptomatically with nonsteroidal anti-inflammatory medications such as ibuprofen for joint pain and fever, and corticosteroid therapy for kidney or heart disease and other serious complications. Hydroxychloroquine or immunosuppressive drugs may work to good effect on joint pain and skin lesions that don't respond to anti-inflammatory drugs.


P R E V E N T I O N
Unfortunately, there is not much one can do to prevent lupus in either form. The causes of lupus are still under investigation, and may include immunologic, genetic, hormonal and infectious factors, though certain pharmaceutical drugs have also been implicated. Flare-ups of the skin rash can be prevented, to some extent, by staying out of the sun.

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