DERMATOLOGY
lupus erythematosus
NAME: MUHAMMAD NOORAIMAN
AHMAD NOORDIN
GROUP : 30 A
Definition
Lupus erythematosus is a category for a collection of
diseases with similar underlying problems
with immunity (autoimmune disease). Symptoms of these
diseases can affect many different body systems, including
joints, skin, kidneys, blood cells, heart, and lungs.
Lupus is an autoimmune disease where the body's immune
system becomes hyperactive and attacks normal, healthy
tissue. When the body's immune system is operating
normally it produces antibodies to fight viruses and
bacteria and other antigens. Lupus makes the antibodies
created unable to differentiate between antigens and
healthy tissue causing the antibodies to attack healthy
tissue. Resulting symptoms include inflammation, swelling,
damage to joints, skin, kidneys, blood, heart and lungs.
Typer of Lupus
Four main types of lupus exist:
systemic lupus erythematosus, (also known as
SLE) is the most common and serious form of
lupus
discoid lupus erythematosus,
drug-induced lupus erythematosus,
neonatal lupus erythematosus
Classification
Lupus erythematosus may manifest as a systemic
disease or in purely cutaneous forms.
Types of lupus erythematosus can be categorized
into the following types:
Complement deficiency syndromes
Drug-induced lupus erythematosus
Neonatal lupus erythematosus
Systemic lupus erythematosus
Acute cutaneous lupus erythematosus
Subacute cutaneous lupus erythematosus
Chronic cutaneous lupus erythematosus
Discoid lupus erythematosus
Childhood discoid lupus erythematosus
Generalized discoid lupus erythematosus
Localized discoid lupus erythematosus
Chilblain lupus erythematosus (Hutchinson)
Lupus erythematosus-lichen planus overlap syndrome
Lupus erythematosus panniculitis (Lupus erythematosus profundus)
Tumid lupus erythematosus
Verrucous lupus erythematosus (Hypertrophic lupus erythematosus)
Symptoms
No two cases of lupus are exactly alike. Signs and symptoms may come on suddenly or develop
slowly, may be mild or severe, and may be temporary or permanent. Most people with lupus have
mild disease characterized by episodes called flares when signs and symptoms get worse for a
while, then improve or even disappear completely for a time.
The signs and symptoms of lupus that you experience will depend on which body systems are
affected by the disease. The most common signs and symptoms include:
Fatigue and fever
Joint pain, stiffness and swelling
Butterfly-shaped rash on the face that covers the cheeks and bridge of the nose
Skin lesions that appear or worsen with sun exposure
Fingers and toes that turn white or blue when exposed to cold or during stressful periods
(Raynaud's phenomenon)
Shortness of breath
Chest pain
Dry eyes
Headaches, confusion, memory loss
Cause
Lupus occurs when your immune system attacks healthy tissue in
your body. It's likely that lupus results from a combination of your
genetics and your environment. It appears that people with an
inherited predisposition for lupus may develop the disease when
they come into contact with something in the environment that can
trigger lupus. The cause for lupus in most cases, however, is
unknown. Some potential triggers include:
Sunlight. Exposure to the sun may bring on lupus skin lesions or
trigger an internal response in susceptible people.
Medications. Lupus can be triggered by certain types of anti-seizure
medications, blood pressure medications and antibiotics. People
who have drug-induced lupus usually see their symptoms go away
when they stop taking the medication.
Complication
Inflammation caused by lupus can affect many areas of
your body, including your:
Kidneys. Lupus can cause serious kidney damage, and
kidney failure is one of the leading causes of death
among people with lupus. Signs and symptoms of
kidney problems may include generalized itching, chest
pain, nausea, vomiting and leg swelling (edema).
Brain. If your brain is affected by lupus, you may
experience headaches, dizziness, behavior changes,
hallucinations, and even strokes or seizures. Many
people with lupus experience memory problems and
may have difficulty expressing their thoughts.
Blood and blood vessels. Lupus may lead to
blood problems, including anemia and increased
risk of bleeding or blood clotting. It can also
cause inflammation of the blood vessels
(vasculitis).
Lungs. Having lupus increases your chances of
developing an inflammation of the chest cavity
lining (pleurisy), which can make breathing
painful.
Heart. Lupus can cause inflammation of your
heart muscle, your arteries or heart membrane
(pericarditis). The risk of cardiovascular disease
and heart attacks increases greatly as well.
Other types of complications
Having lupus also increase your risk of:
Infection. People with lupus are more vulnerable to infection
because both the disease and its treatments weaken the immune
system. Infections that most commonly affect people with lupus
include urinary tract infections, respiratory infections, yeast
infections, salmonella, herpes and shingles.
Cancer. Having lupus appears to increase your risk of cancer.
Bone tissue death (avascular necrosis). This occurs when the blood
supply to a bone diminishes, often leading to tiny breaks in the
bone and eventually to the bone's collapse. The hip joint is most
commonly affected.
Pregnancy complications. Women with lupus have an increased
risk of miscarriage. Lupus increases the risk of high blood pressure
during pregnancy (preeclampsia) and preterm birth. To reduce the
risk of these complications, doctors recommend delaying pregnancy
until your disease has been under control for at least 6 months.
Treatment
Treatment for lupus depends on your signs and symptoms.
Determining whether your signs and symptoms should be treated
and what medications to use requires a careful discussion of the
benefits and risks with your doctor. As your signs and symptoms
flare and subside, you and your doctor may find that you'll need to
change medications or dosages. The medications most commonly
used to control lupus include:
Nonsteroidal anti-inflammatory drugs (NSAIDs). Over-the-counter
NSAIDs, such as naproxen (Aleve) and ibuprofen (Advil, Motrin,
others), may be used to treat pain, swelling and fever associated
with lupus. Stronger NSAIDs are available by prescription. Side
effects of NSAIDs include stomach bleeding, kidney problems and
an increased risk of heart problems.
Antimalarial drugs. Medications commonly used to treat malaria,
such as hydroxychloroquine (Plaquenil), also can help control lupus.
Side effects can include stomach upset and, very rarely, damage to
the retina of the eye.
Corticosteroids. Prednisone and other types of corticosteroids can
counter the inflammation of lupus, but often produce long-term
side effects including weight gain, easy bruising, thinning bones
(osteoporosis), high blood pressure, diabetes and increased risk of
infection. The risk of side effects increases with higher doses and
longer term therapy.
Immune suppressants. Drugs that suppress the immune system
may be helpful in serious cases of lupus. Examples include
cyclophosphamide (Cytoxan), azathioprine (Imuran, Azasan),
mycophenolate (Cellcept), leflunomide (Arava) and methotrexate
(Trexall). Potential side effects may include an increased risk of
infection, liver damage, decreased fertility and an increased risk of
cancer. A newer medication, belimumab (Benlysta) also reduces
lupus symptoms in some people. Side effects include nausea,
diarrhea and fever.