Lupus Erythematosus
An autoimmune disease that can affect many organs
Quick Facts
- Type: Autoimmune disease
- Commonly affects: Skin, joints, kidneys, blood
- More common in: Women of childbearing age
- Course: Chronic, with flares and remissions
Overview
Lupus erythematosus is a chronic autoimmune disease in which the immune system, which normally defends the body against germs, mistakenly attacks healthy tissues. This causes inflammation that can affect many parts of the body. The most common and serious form is systemic lupus erythematosus (SLE), which can involve the skin, joints, kidneys, heart, lungs, blood, and brain. Other forms mainly affect the skin.
Lupus is more common in women, especially during the childbearing years, and tends to follow a pattern of flares, when symptoms worsen, and remissions, when they ease. There is no cure, but with treatment most people are able to control the disease and lead active lives.
Symptoms
Lupus symptoms vary widely and can mimic other illnesses. Common features include:
- Fatigue and fever
- Joint pain, stiffness, and swelling
- A butterfly-shaped rash across the cheeks and nose
- Skin rashes that worsen with sun exposure
- Mouth or nose sores
- Hair loss
- Fingers turning white or blue in cold (Raynaud phenomenon)
- Chest pain when breathing deeply
When lupus affects internal organs, it can cause kidney problems, blood count changes, and effects on the heart, lungs, or nervous system.
Causes
The exact cause of lupus is not fully understood, but it results from a mix of factors that lead the immune system to attack the body:
- Genetics: Certain inherited traits make lupus more likely.
- Hormones: The disease is far more common in women, suggesting hormones play a role.
- Environment: Sunlight, infections, stress, and some medications can trigger or worsen lupus.
In most cases lupus develops from a combination of these influences rather than a single cause.
Risk Factors
- Being female, especially between the teens and forties
- A family history of lupus or other autoimmune diseases
- Certain ancestries, including African, Hispanic, and Asian backgrounds, in which lupus is more common
- Sun exposure
- Some medications that can trigger a lupus-like reaction
Diagnosis
Lupus can be difficult to diagnose because its symptoms overlap with many other conditions and can come and go over time. Doctors use a combination of:
- Medical history and exam: Looking at the pattern of symptoms and how they evolve, since lupus often affects several body systems.
- Blood and urine tests: Including tests for specific autoantibodies (such as ANA and others), blood counts that may show anemia or low cell counts, and urine tests that check for kidney involvement.
- Tissue biopsy: Of the skin or kidney when needed to assess the degree of inflammation and damage.
No single test confirms lupus; the diagnosis is based on the overall picture, and it may take time and repeated visits to reach a firm conclusion.
Treatment
Treatment aims to control inflammation, prevent flares, and protect organs:
- Anti-inflammatory drugs: NSAIDs for joint pain and inflammation.
- Antimalarial medication: Hydroxychloroquine, a mainstay that reduces flares and protects organs.
- Corticosteroids: To calm more severe inflammation.
- Immune-modifying drugs: For significant organ involvement.
- Sun protection: Avoiding sun and using sunscreen to prevent skin and disease flares.
Treatment is tailored to each person and adjusted over time, often with care from a rheumatologist.
Self-Care and Prevention
- Protect your skin from the sun with sunscreen, clothing, and shade
- Take medications as prescribed and keep regular checkups
- Rest during flares and balance activity with recovery
- Avoid smoking, which can worsen lupus
- Manage stress and treat infections promptly
When to See a Doctor
See a doctor for persistent fatigue, unexplained joint pain, a facial rash, or other ongoing symptoms that could point to lupus. Seek emergency care for severe chest pain, trouble breathing, sudden swelling, a severe headache with confusion or vision changes, seizures, or signs of a serious infection, as lupus and its treatments can sometimes cause life-threatening complications.
Frequently Asked Questions
What is lupus erythematosus?
It is a chronic autoimmune disease in which the immune system attacks the body's own tissues, causing inflammation. The most common form, systemic lupus erythematosus, can affect the skin, joints, kidneys, and other organs.
Is lupus contagious?
No. Lupus is not an infection and cannot be spread from person to person. It develops from a combination of genetic, hormonal, and environmental factors that cause the immune system to malfunction.
Can lupus be cured?
There is currently no cure for lupus, but it can be effectively managed. With medication, sun protection, and regular care, most people are able to control flares and lead active lives.
Why does sunlight affect lupus?
Ultraviolet light from the sun can trigger skin rashes and even broader disease flares in many people with lupus. Using sunscreen, wearing protective clothing, and avoiding strong sun help reduce these flares.
What is the butterfly rash?
The butterfly rash is a reddish rash that spreads across the cheeks and bridge of the nose, resembling a butterfly's wings. It is a classic sign of lupus, though not everyone with lupus develops it.
References
- National Institute of Arthritis and Musculoskeletal and Skin Diseases (NIAMS). Lupus.
- Mayo Clinic. Lupus — Symptoms and causes.
- Centers for Disease Control and Prevention (CDC). Systemic lupus erythematosus (SLE).
- MedlinePlus, U.S. National Library of Medicine. Lupus.