Lupus is an ulcerative skin disease that involves impairments of the immune system and determines the body to destroy its own healthy cells and tissues, lupus is defined as an autoimmune disease. A major characteristic of lupus and autoimmune diseases in general is the multitude of generated symptoms. When the compromised immune system becomes confused and targets healthy blood cells and tissues instead of external antigens, the disease can affect virtually any part of the body, producing a wide variety of symptoms that are often uncharacteristic to autoimmune diseases in general. Lupus commonly affects the joints, skin, blood vessels, heart, lungs and even the brain (central nervous system).

Signs and Symptoms

• Fatigue.
• Body weakness.
• Pain, swelling and stiffness of the joints.
• Fever.
• Kidney affections.
• Skin rashes.
• Muscle aches.
• Loss of appetite.
• Hair loss.
• A butterfly-shaped rash across the nose and cheeks (malar).
• Sores in the nose or mouth.
• Seizures. Neurologic disorder.
• A lower than normal number of red blood cells (anemia), white blood cells, or platelets.
• Serositis. Pleuritis (inflammation of the membrane around the lungs).
• Pericarditis (inflammation of the membrane around the heart).
• Sensitivity (exposure to ultraviolet light causes skin rash, or other symptoms of Lupus flareups).

Causes

The medical term “Lupus” comprises a variety of distinctive types that can be classified as follows:

1. Systemic Lupus Erythematosus (SLE): the most common type of lupus and is the most dangerous form of lupus, which has a pronounced polyvalent character. The systemic form of lupus can affect the immune system attacks any system or organ in the body including the joints, skin, lungs, heart, blood, blood vessels, kidney, heart, liver, brain, tendons, pancreas, or nervous system, and cause a wide variety of unspecific symptoms, ranging from mild to severe. Despite the fact that SLE commonly affects people with ages between 15 and 40, it can also affect the very young or the elderly. Over 50 percent of all systemic lupus patients in the United States have some degree of brain inflammation. Between 3 and 20 percent suffer strokes. Some of the other more common symptoms are kidney damage, chronic fatigue and painful or swollen joints.
2. Discoid Lupus Erythematosus (DLE): is less harmful than SLE because it only affects the skin. DLE causes disc-shaped, red, raised rashes (discoid) to appear on the cheeks, face, neck, scalp, ears, or other parts of the body. In the absence of the appropriate treatment, discoid lupus can become systemic over the course of time. In its first stages of progression, discoid lupus produces inflammation and rashes on the face, scalp, or other body regions. In time, the rashes become prominent, thickened and may even increase in size. The skin lesions caused by discoid lupus may also involve scaling and blistering. Although lupus rashes may ameliorate or even completely clear up with the aid of treatment, they tend to recur after a certain amount of time.
3. Drug-induced lupus erythematosus (DILE): is a rare form of the disease that occurs as a result using of certain drugs. Some of these drugs include hydralazine, procainamide, antiseizure medicines and acne medicines. Cocaine use and exposure to mercury can also induce DILE. Between 10,000 and 15,000 Americans are diagnosed with DILE every year. The symptoms of DILE are similar to those of SLE, although the symptoms are usually less pronounced: rash, unexplained fever, pulmonary and coronary affections, and arthritis. However, unlike the systemic form of the disease, drug-induced lupus doesn’t involve kidney impairments and often disappears as soon as the causative drugs are no longer administered. The most common medications that have been identified to cause drug-induced lupus erythematosus are: hydralazine (Apresoline), methyldopa (Aldomet), procainamide (Procan), isoniazid (INH), quinidine (Quinaglute), phenytoin (Dilantin) and carbamazepine (Tegretol).
4. Neonatal lupus: is a rare condition acquired by babies from mothers who have SLE or another immune system disorder. Infants affected by this type of lupus often suffer from congenital heart and circulatory problems. Sometimes, infants with neonatal lupus may also suffer from liver problems, skin rash and low blood cell counts. When the disease is promptly diagnosed, the young patients’ life expectancy and overall condition can be improved with treatment. Prompt medical intervention is crucial for patients with suspected neonatal lupus.

Treatments

Drug-Induced Lupus Treatment is:

• Hydralazine (treat muscle relaxant and hypertension).
• Penicillamine (a heavy metal antagonists is used in the treatment of arthritis and arthritic conditions).
• Methyldopa (treatment for hypertension).
• Isoniazid (treatment and prevention of tuberculosis).
• Procainamide (treatment for abnormal heart rhythms).
• Quinidine (treatment or prevention of irregular heartbeats).
• Sulfasalazine (treatment for mild to moderate ulcerative colitis; Crohn’s disease, and rheumatoid arthritis).
• Thorazine (anti-psychotic medication).
• Aspirins, naproxen-sodium, and ibuprofen. (Sometimes prescription strength is required, but more often then not, over the counter anti-inflammatory drugs have been doing the trick).
• Corticosteroids (Aid in decreasing the inflammation in joint swelling, and swelling around the heart and lungs. Corticosteroids can cause serious side effects if not closely monitored).
• Anti-malarial drugs (The connection between lupus and malaria are not yet known, but have found that these drugs help with the skin rashes, fatigue, and swelling around the heart and lungs caused by lupus.
• Immune-suppressive drugs, such as Cytoxan, Imuran, and CellCept (used in the treatment of serious cases of lupus, carry hefty possible side effects and require close monitoring.

Systemic Lupus Erythematosus Treatment.

• Nonsteroidal antiinflammatory drugs (NSAIDs): such as Daypro, Aleve, Ansaid, actron, Mobic. Motrin are helpful in reducing inflammation and pain in muscles, joints, and other tissues.
• Corticosteroids are more potent than NSAIDs in reducing inflammation and restoring function when the disease is active.
• Hydroxychloroquine (Plaquenil) is an antimalarial medication found to be particularly effective for SLE patients with fatigue, skin, and joint disease. Side effects include diarrhea, upset stomach, and eye pigment changes.
•  Cytotoxic is immunosuppressive medications are used for treating patients with more severe manifestations of SLE with damage to internal organ.
• mycophenolate mofetil (Cellcept) has been used as an effective medication for lupus, particularly when it associated with kidney disease.
• Plasmapheresis is used In SLE patients with serious brain or kidney disease to remove antibodies and other immune substances from the blood to suppress immunity.
• omega-3 fish oils supplementation: could help patients with lupus by decreasing disease activity and possibly decreasing heart disease risk.
• Rituximab is an intravenously infused antibody that suppresses a particular white blood cell, the B cell, by decreasing their number in the circulation.
• Patients with lupus needed plenty of rest, sleep and exercise to build strength immune system.
• Disease-modifying antirheumatic drugs (DMARDs) are used preventively to reduce the incidence of flares.
• Avoiding direct sunlight, covering up with sun-protective clothing and using strong UVA/UVB sunblock lotion can also be effective in preventing photosensitivity problems.
• Weight loss is also recommended in overweight and obese patients to alleviate some of the effects of the disease, especially where joint involvement is significant.

Discoid Lupus Erythematosus Treatment

• Avoiding sun exposure and the use of sunscreens.
• Corticosteroids is used for topical treatment.
• Oral vitamin E or omega-3 and omega-6 fatty acids are also used.
• Antimalarial medications such as hydroxychloroquine or plaquinil and others.
• Oral medications sucha as niacinamide and tetracycline, corticosteroids, azathioprine, or chlorambucil for more refractory cases.