Lupus - Questions and Answers

Questions and Answers

Lupus erythematosus, one of a group of disorders known as the collagen diseases, takes two distinct but unrelated forms: discoid lupus erythematosus (DLE) and systemic lupus erythematosus (SLE). Both conditions affect the skin. SLE, also known as disseminated lupus erythematosus, involves other tissues and organs as well. It is purportedly an autoimmune disease associated with the presence of antibodies to DNA and other substances found in the cell nucleus.

Collagen is a fibrous, insoluble protein in connective tissue. Both DLE and SLE affect the connective tissue, but are of unknown cause or causes. It is often difficult to distinguish between the two conditions. Much confusion has arisen because the skin lesions are the same in both diseases. Other features, though, are distinctive.

Q:What are the symptoms of DLE

A:DLE is a chronic skin disorder that occurs most commonly in middle-aged women. It produces thickened, slightly scaly, reddened patches on the face, cheeks, and forehead. After a few weeks or months, atrophy, pigmentary changes, and telangiectasia (dilated capillaries) are visible. The patches sometimes spread to the scalp and cause hair loss. Sunlight makes the condition worse, so in some patients it virtually disappears during the winter months. Nearly all patients with DLE remain in good health apart from the skin disorder. It is exceptionally rare for patients with DLE to develop SLE.

Q:How is chronic DLE treated

A:patients with DLE should wear hats and sunscreen to protect their skin. Also, corticosteroid skin creams may be helpful, but should be used only under medical supervision. Ultimately, some of the lesions heal on their own.

In severe cases, hydroxychloroquine (a drug used to treat malaria) may be beneficial. But, because this drug rarely has an effect on the eyes, it should be used with great caution.

Q:What are the symptoms of SLE

A:The patient may have the same kind of rash as in DLE. There may also be fever, arthritis, and signs of problems with lung, kidney, and heart function. Unlike DLE, SLE is a generalized condition that may affect not only the face, but also many other tissues of the body, especially the kidneys.

Q:How is SLE diagnosed and treated

A:A knowledge of the patient's history combined with discovery of abnormalities in blood tests will help diagnosis. Treatment with corticosteroids may help. Other drugs for treatment include antimalarial drugs and immunosuppressants such as azathioprine.

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