There are Four Distinct Types of Lupus:
1. Systemic Lupus Erythematosus
Often referred to as SLE or lupus and the most common form. This auto-immune disease affects one or more of the patient’s major organ systems such as the brain, lungs, heart, liver, kidneys, skin, and joints, with an active episode of symptoms called a flare. The immune system is the body’s natural defense against infections such as bacteria and viruses however, in patients suffering from SLE, the immune system produces antibodies that react adversely with certain tissues and organs – basically the body becomes allergic to itself.
2. Discoid (Cutaneous) Lupus Erythematosus
Mainly affects the patient's skin, with a rash appearing on the face, neck or scalp. The affected, raised areas may become thick and scaly and cause scarring, with the rash lasting for days or even years. A small percentage of patients with discoid lupus have or develop SLE later.
3. Subacute Cutaneous Lupus Erythematosus
Refers to psoriasis-like skin lesions that appear on parts of the body that are exposed to the sun such as the arms, shoulders and neck, with fewer patches on the face. These lesions usually do not cause scarring.
4. Drug-Induced Lupus
Is triggered by select medications. Unlike SLE or discoid lupus, this type affects more men than women. It is usually brought on by drugs such as Hydralazine and Procainamide, which are primarily used to treat heart conditions in men. Drug-induced lupus affects a patient the same way as SLE, however the symptoms are generally more mild. When the drugs are discontinued, these symptoms usually disappear.
What are the Signs of Lupus?
The signs (or symptoms) of lupus differ from one person to another. Some people may have just a few signs of the disease; others may have more. Regardless of the type, lupus is a chronic condition which can cause a myriad of sometimes debilitating symptoms which include:
- Red rash (often in the shape of a butterfly) across the bridge of the nose and cheeks
- Kidney dysfunction
- Painful joints and muscles
- Unexplained low-grade fever
- Chest pains with breathing
- Unusual loss of hair
- Pale or purple finger tips or toes - known as Raynaud's phenomenon
- Sensitivity to sunlight
- Low blood count
- Extreme fatigue
- Mouth sores
The exact cause(s) of this disease is currently unknown, but it is believed that both genetic and environmental factors play a role. Those with family pre-disposition to connective tissue disorders have been found to be at higher risk of developing the disease. Prolonged sun exposure, specifically to UVA and UVB rays, can result in the tell-tale butterfly rash across the face and is a high contributor to lupus flares. So is extreme stress. Some environmental agents may also cause activation of the disease as well as infections and/or antibiotics (from both the sulfa and penicillin families).
Because lupus is notorious for mimicking a vast array of other diseases, it is extremely difficult to diagnose. Doctors rely on extensive bloodwork, including an ANA (antinuclear antibody) test – if found positive, this signals a unique group of autoantibodies have attacked the nucleus of specific white blood cells. Immediate treatment is then required, and usually involves mass doses of steroids.
Overall, many patients diagnosed with lupus experience minimal organ involvement. For others, especially African-American women, the percentage of organ involvement is higher and can be a serious or deadly illness.
For more information, continue to browse our website, or go to or www.CouldIHaveLupus.gov
Who Does Lupus Affect?
It's estimated that as high as two million people in the US suffer from lupus, with more than 16,000 new cases being reported annually. Primarily occurring in women during childbearing years, lupus patients can range in age from 8 to 85 years. Between the ages of 15 and 45, 90% of those diagnosed with SLE are women. This percentage drops with other forms - 70% to 80% diagnosed with discoid lupus are women and the condition occurs equally in men for drug-induced lupus. Neonatal lupus even affects infants whose mothers carry a specific antibody.
An ethnicity breakdown shows that in the US, African-American women are diagnosed 3 out of 5 times more often than Caucasian women, followed closely by Hispanics and then Asians.
Unfortunately, the condition is being detected much later in men than that of female patients, mainly due to the general lack of awareness of male symptom manifestations by both the public and medical personnel. The net result of this ignorance is delay in medical care, aggravated by men’s reticence to seek assistance when they are feeling ill.
What Treatments are Available?
Treatment for lupus varies according to the type and severity of the patent's condition. Most often, drug therapies revolve around anti-inflammatory medications which include aspirin products and nonsteroidal anti-inflammatory drugs or NSAIDs such as Ibuprofen (Advil, Motrin), Naproxen (Aleve), Etodolac (Lodine) and Nabumetone (Relafen).
Based on organ involvement, a physician may prescribe an antimalarial such as Plaquenil which is used to treat high fever and related symptoms or steroids like Prednisone (oral) or Hydrocortisone (local/topical) which deals directly with inflammation. In acute cases, a patient may need to undergo intravenous steroid or chemotherapy treatment, which can be administered in larger doses at a quicker rate.
Although steroids are a vital component to lupus recovery and survival, unfortunately, they cause severe side effects such as rapid heart rate, bruising and central obesity, even when taken in small, moderate doses. Extreme side effects include bone loss, diabetes and psychotic behavior.
There is currently no cure for lupus, but new advancements are being discovered each day by dedicated medical professionals through research and clinical trials. In fact in July 2009, the scientific world announced the success of an experimental treatment, BENLYSTA, which greatly reduced symptoms of the auto-immune disorder. After a 50-year drought of new drugs to fight lupus, the entire lupus community is celebrating the possibility of ensuring an increased quality of life by ameliorating the symptoms of this life-threatening disease.
What Can I Do Today?
Preventing a flare is key to healthy and normal living. You can do this by:
- Learning to recognize when a flare is coming on.
- Keeping up honest and open communication with your doctor.
- Setting realistic life goals and priorities.
- Limiting sun exposure.
- Maintaining a healthy diet and exercise regimen (when possible).
- Developing a support system by surrounding yourself with family and friends that you can rely on and trust.
- Limiting stress and utilizing effective coping skills.
Contact a Rheumatologist if you have any of the symptoms listed above to get checked for lupus.