Lupus is an autoimmune disease. Although, it is now considered a common illness, affecting more people than multiple sclerosis and leukemia worldwide, few people have heard of it.
An autoimmune disease (“auto”- meaning self) is where the body’s own defence system , which is there to fight against infection and disease, becomes overactive and fights the body itself.
It is a very complex disease for which there is no cure. As in other autoimmune diseases, such as rheumatoid arthritis and Crohn’s disease, it can be very unpredictable, repeatedly flaring up and going into remission over time.
Common symptoms can include any of the following: extreme fatigue, flu like fevers, arthritis, muscle pain, mouth ulcers, skin rashes, hair loss, depression, kidney disease, miscarriage and blood disorders.
In Systemic Lupus Erythematosus (SLE) the severest form of the disease, the immune system can attack any part of the body including internal organs, such as, the heart, lungs and kidneys, as well as the skin.
Another type of Lupus is Discoid lupus (DLE) also referred to as cutaneous lupus. In this form of lupus, the immune system attacks the skin resulting in painful red patches that can then thicken and scar. It is a distressing condition and these markings often occur on the face, neck, hands and feet, however unlike SLE, DLE does not affect the internal organs and is never life threatening.
Although, there is no cure for this disease, it can be managed through drugs and lifestyle changes and the outlook for those with lupus has substantially improved, over the past 40 years.
The name “lupus” comes from the Latin word for “wolf” and is thought to derive from wolf like markings on the face, now more commonly described as a red “butterfly” shaped rash which is often associated with Lupus, which appears on the forehead, nose and cheeks.
Lupus affects everyone who has it differently. For some people it can be very mild, for others it can be life threatening. It affects more women than men, 9 out of 10 people who have it are female and it is thought to be linked to female hormones, as it often strikes women of childbearing age. Within this group it is more common in women of Afro-Caribbean or Asian origin, although no one knows why.
It is common for people with lupus to also suffer from sun sensitivity, which, as well as triggering painful rashes can also cause flare ups of the condition up to two weeks after the original sun exposure. So people with lupus are advised to wear high SPF sun lotions, long sleeves, hats and sunglasses and avoid extensive sun exposure.
Medications most commonly used in the treatment of lupus are: steroids, antimalarials, non- steroidal anti-inflammitory drugs (NSAIDs) and immunosuppressants.
Because lupus is such a complex condition, getting a diagnosis can be difficult. The American College of Rheumatology (ACR) developed a list of criteria for diagnosing lupus and specialists will look at these criteria as a guide together with blood tests. The presence of four or more of the criteria may point towards a diagnosis of lupus.
The ACRs criteria are:
- Butterfly rash over the cheeks (molar rash)
- Discoid rash
- Sun sensitivity
- Oral ulcerations
- Kidney disorder
- Neurologic disorder
- Blood abnormalities
- Immunologic disorder
- Positive ANA blood test
There are also some other conditions that are frequently linked to lupus. These are: Hughes syndrome, Sjogren’s syndrome, Raynaud’s phenonomen, Fibromyalgia and Myositis.