Educational Lupus Information

Antimalarials are aimed at reducing the skin lesions and inflammation differentiating to lupus. These drugs are generally used in both discoid and systemic lupus treatments.


The process of diagnosing discoid lupus erythematosus involves physical examination, laboratory another look of graze samples and elaborate blood tests. If laboratory tests distinguish dysfunctions of the immune plan again the skin lesions are linked to discoid lupus erythematosus, the patients will be prescribed an designate medical treatment. Although the disorder can’t be fully overcome since the means of the medical treatments available today, discoid lupus erythematosus can be controlled besides its generated symptoms answerability be ameliorated. Patients diagnosed duck discoid lupus erythematosus need to elude pedantry to sunlight juice order to prevent strain of their skin lesions again the formation of permanent scars.

Statistics indicate that there are around 2 million kinsfolk diagnosed with Lupus each year. An estimated 90 percent of the affected connections are sex. because some reason, Lupus has the prime incidence in young women and many of them show up the disease after tender age. The disorder also occurs credit infants, quite young children and elderly people. African American and Asian womanliness are submerged fresh touchy to developing Lupus than white women. Research results indicate that the incidence of Lupus in black women is advancement to 3 times higher than in white women. Asian and Hispanic women are usually affected by Lupus at a young age again experience more pronounced forms of the malady.

In the discoid parent of lupus, the rash occurs mastery different regions of the body and it affects larger patches of skin. Discoid lupus rash involves hyperpigmentation of the skin, exfoliation and the formation of crust. The skin lesions characteristic to discoid lupus erythematosus can affect deeper layers of graze also they usually heal shroud scarring. When it occurs on the scalp, discoid lupus mange constraint involve temporary or permanent hair loss (alopecia). If the rash is accompanied by intense scaling, papules besides crust, the skin may heal cache pronounced scarring.

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This information is for"informational purposes" and is not meant to be used for medical diagnosis. Always consult your physician on matters such as this.

Lupus: Treatment, Symptoms and more

The treatment for systemic lupus erythematosus is mainly targeted at
reducing the damage caused by the dysfunctional immune system to
the body. Immunosuppressive medications are very common in the
treatment for lupus. Although they can generate pronounced
side-effect, corticosteroids are often used in the treatment of
systemic lupus erythemaosus.


However, doctors are trying to minimize the use of harmful drugs
such as azathioprine (Imuran) and cyclophosphamide (Cytoxan).

Discoid lupus erythematosus is a condition of the skin that generates
localized or widespread circular lesions. Discoid lupus erythematosus
is a chronic autoimmune condition. Instead of protecting the body
against infectious organisms, certain dysfunctions of the immune
system cause it to attack healthy body cells and tissues, producing
lesions on the surface of the skin. The skin lesions caused by discoid
lupus erythematosus can aggravate due to prolonged exposure to
the sun.

Most patients have localized skin lesions, predominantly on the body
regions exposed to sunlight: scalp, face, neck and arms. However,
some patients have skin lesions on unexposed regions of the body:
chest, back or legs. These lesions canindicate the development of
systemic lupus erythematosus, which involves serious abnormalities
of the immune system.

Discoid lupus erythematosus is very common in women with ages
between 18 and 50 and it rarely occurs in men. The skin disorder has
the highest incidence in African American women, who commonly
experience more intense symptoms of discoid lupus erythematosus.
Although the actual causes of the disorder have not been identified,
multiple inter-related factors are suspected for triggering the
condition: genetic factors (inherited genetic abnormalities),
hormonal factors (excessive levels of estrogen seem to facilitate the
development of the disorder) and environmental factors (prolonged
medical treatments with antibiotics).

Discoid lupus erythematosus has a pronounced hereditary character,
as the majority of affected people have a family history of the
disorder. Systemic Lupus Erythematosus is an autoimmune disease
that can cause a wide range of dysfunctions.

Lupus involves abnormal activity of the immune system, causing it
to attack the healthy blood cells of the body instead of protecting
them from external infectious agents.

Systemic Lupus Erythematosus can determine various disorders,
affecting the skin, heart, kidneys, lungs, musculoskeletal system,
nervous system and brain. Considering the fact that systemic lupus
erythematosus generates various uncharacteristic symptoms, it is
very difficult to diagnose the disease relying only on physical
examinations and patients’ reports of their symptoms. Many
symptoms of systemic lupus erythematosus can be actually
misleading in the process of diagnosing the disease.

Lupus can be correctly diagnosed only through the means of blood
analyses and laboratory tests. If some of the patients’ experienced
symptoms are linked to systemic lupus erythematosus, the medical
treatment will be established according to the affected persons’
overall health condition.

=========================================================== This information is for"informational purposes" and is not meant to be used for medical diagnosis. Always consult your physician on matters such as this.

Work Disability Among People With Lupus

Being unable to work has a profound impact on chronically ill people and their families. Self esteem, socializing with peers, current income, and retirement assets can all be greatly reduced when a person becomes work disabled. Arthritis Foundation-funded researcher Ed Yelin, PhD, and his team at University of California, San Francisco, assessed the work patterns of people with systemic lupus erythematosus (SLE or lupus) at diagnosis and several years after diagnosis.What Problem Was Studied?Because lupus often begins at a fairly young age, during a person’s career-building phase of life, those people have a lot to lose if they cannot work.

If diagnosed at age 30 and work disabled by age 35, a person with lupus may lose up to 30 years of income and have no money saved for retirement. To determine the levels of work disability and characteristics of people who become disabled, Dr. Yelin and team studied a large group of people with lupus over a number of years.What Was Done In the Study?Participants of a genetic study of lupus were recruited for the Lupus Outcomes Study (LOS). Of those in the genetics study, 982 enrolled in the LOS and answered questions to an initial interview. One year later, 832 of the participants answered the same questions again. The survey gathered data about the following:
demographics and socioeconomic status – age, sex, ethnicity, education, income;

SLE status – disease activity, disease manifestations;
general health – height and weight, smoking status, diseases other than lupus;
mental health – depression, cognitive function, stress;
health insurance – type of coverage, copayments, drug coverage;
health care utilization – number of doctor visits, medications taken, hospitalizations; and
employment – if working, number of hours per week, number of weeks per year, occupation, demands of job.

What Were the Study Results?The LOS participants had lupus for an average of ~12 years. Overall, 74% had been employed in the year of diagnosis, declining to 55% at the time of the first LOS interview and to 54% a year later at the second LOS interview. Among participants who had ever been employed, hours worked per week declined by ~35% between the year of diagnosis and the second interview; weeks worked per year declined by ~24%; and total hours worked per year declined by ~32%. By 5 years after diagnosis, 15% had stopped working; by 10 years, ~36%; by 15 years, 51%; and by 20 years, 63% had stopped working. These numbers represent a much lower employment rate than a similar group without SLE.

What Does This Mean For People With Lupus?Among these people with lupus, diagnosis occurred in their mid-30s. More than half of those lost 20 years of earning potential. As Dr. Yelin notes in the article’s summary “Because much of the accrual of retirement savings occurs in these last two decades of a career, after one’s responsibilities to one’s children have passed, persons with SLE will have to face retirement with a much greater risk of poverty.” This grim reality brings to the forefront a need for occupational therapy and work maintenance programs that can help people with chronic diseases remain in the workforce. To reduce employment loss, Dr. Yelin recommends, “People with SLE must work with their employers to receive the job accommodations that are their due under the Americans with Disabilities Act (ADA). In particular, flexible work schedules have proven helpful so that those with serious illnesses can fit their illness episodes and need to obtain health care in and around work activities.”

Yelin E, Trupin L, Katz P, et al. Work dynamics among persons with systemic lupus erythematosus. Arthritis Rheum (Arthritis Care Res) 2007;57:56-63.

=========================================================== This information is for"informational purposes" and is not meant to be used for medical diagnosis. Always consult your physician on matters such as this.

What Are The Four Types of Lupus?

There are four types of lupus: discoid, systemic, drug-induced and neonatal lupus.

Discoid
Discoid (cutaneous) lupus is always limited to the skin. It is identified by a rash that may appear on the face, neck, and scalp. Discoid lupus is diagnosed by examining a biopsy of the rash. In discoid lupus the biopsy will show abnormalities that are not found in skin without the rash. Discoid lupus does not generally involve the body's internal organs. Therefore, the ANA test may be negative in patients with discoid lupus. However, in a large number of patients with discoid lupus, the ANA test is positive, but at a low level or "titer."

In approximately 10 percent of patients, discoid lupus can evolve into the systemic form of the disease, which can affect almost any organ or system of the body. This cannot be predicted or prevented. Treatment of discoid lupus will not prevent its progression to the systemic form. Individuals who progress to the systemic form probably had systemic lupus at the outset, with the discoid rash as their main symptom.

Systemic
Systemic lupus is usually more severe than discoid lupus, and can affect almost any organ or organ system of the body. For some people, only the skin and joints will be involved. In others, the joints, lungs, kidneys, blood, or other organs and/or tissues may be affected. Generally, no two people with systemic lupus will have identical symptoms. Systemic lupus may include periods in which few, if any, symptoms are evident ("remission") and other times when the disease becomes more active ("flare"). Most often when people mention "lupus," they are referring to the systemic form of the disease.

Drug-Induced
Drug-induced lupus occurs after the use of certain prescribed drugs. The symptoms of drug-induced lupus are similar to those of systemic lupus. The drugs most commonly connected with drug-induced lupus are hydralazine (used to treat high blood pressure or hypertension) and procainamide (used to treat irregular heart rhythms). Drug induced lupus is more common in men who are given these drugs more often. However, not everyone who takes these drugs will develop drug-induced lupus. Only about 4 percent of the people who take these drugs will develop the antibodies suggestive of lupus. Of those 4 percent, only an extremely small number will develop overt drug-induced lupus. The symptoms usually fade when the medications are discontinued.

Neonatal
Neonatal lupus is a rare condition acquired from the passage of maternal autoantibodies, specifically anti-Ro/SSA or anti-La/SSB, which can affect the skin, heart and blood of the fetus and newborn. It is associated with a rash that appears within the first several weeks of life and may persist for about six months before disappearing. Congenital heart block is much less common than the skin rash. Neonatal lupus is not systemic lupus.


=========================================================== This information is for"informational purposes" and is not meant to be used for medical diagnosis. Always consult your physician on matters such as this.

Fertility Preserved in Women With Severe Lupus

Ovarian function can be preserved and disease activity controlled in women with severe systemic lupus erythematosus (SLE; lupus) when treated with a 6-month course of cyclophosphamide (CYC), a chemotherapy drug, followed by the immunosuppressant mycophenolate mofetil (MMF), according to a new study presented at the Annual Congress of the European League Against Rheumatism. Lupus is most common among women and, although long-term survival has dramatically improved over time with better diagnosis and treatment options, one of the challenges in managing the disease is to minimize the side-effects of treatments such as the disruption of ovarian function and risks to fertility.

Pulsed intravenous CYC is a standard therapy for SLE but may also be associated with ovarian failure in addition to other adverse effects.Dr. Katerina Laskari, the presenting author of the study, led by Professor Athanasios G. Tzioufas in the Department of Pathophysiology of the National and Kapodistrian University of Athens, said: "Although the prognosis for people with SLE has considerably improved over the years, a patient's quality of life can all too often be seriously impaired by the toxicity of many commonly used treatments. Preserving ovarian function is a very important consideration in treating women with SLE of child-bearing age, who are already burdened by the difficult nature and impact of the disease itself."

This article was adapted from a press release issued by EULAR.

=========================================================== This information is for"informational purposes" and is not meant to be used for medical diagnosis. Always consult your physician on matters such as this.

Poverty & Lupus

It is a well-established fact that poor people with chronic disease have poorer outcomes than well-off people with chronic disease. People with lupus have not been able to escape this reality. Research in diseases other than lupus has shown that characteristics of the neighborhood in which people live can also affect a person’s health. For example, studies done by sociologists have shown that living in a poverty-stricken area accentuates the negative effects of being poor yourself.

What Problem Was Studied?
Because of the results of the sociological research, health science researchers – led by Laura Trupin, MPH, and including Arthritis Foundation-funded scientists Jinoos Yazdany, MD, MPH, Lindsey A. Criswell, MD, and Edward Yelin, PhD – decided to examine the joint effects of personal poverty and neighborhood poverty on the health of people with systemic lupus erythematosus (SLE; lupus).

What Was Done in the Study?
The team from University of California, San Francisco, used data from the Lupus Outcomes Study to determine the contribution of neighborhood socioeconomic status (SES) to lupus outcomes over and above the contribution of individual SES. Individual SES was determined using three measurements: educational attainment, annual household income and poverty level. Participants were considered to be living in poverty if their income and number of people in the house put them at or below 125 percent of the federal poverty threshold. For a family of four, this translated to an annual income of less than $23,000.Neighborhood SES was determined by the percentage of households in a neighborhood living at or below 125 percent of the federal poverty threshold. If 30 percent of households are below that level, the neighborhood is considered a high poverty area.As well as obtaining this economic information, the research team also gathered data on the participants’ health. For this study, they measured disease activity, overall physical functioning and symptoms of depression.

What Were the Study Results?
After adjusting for confounding variables, lower education, lower income and poverty all were associated with higher disease activity, poorer physical function and more depression. Likewise, living in a high poverty area was also associated with greater lupus activity, poorer physical function and higher likelihood of depression. When evaluating the simultaneous effect of low individual SES and high levels of neighborhood poverty, however, neighborhood poverty had an adverse impact on only the mental health of people with lupus. Of participants who were personally poor and lived in a poor neighborhood, 76 percent had clinically significant depression, whereas just 32 percent of those who were neither poor nor lived in a poor area had scores indicative of depression.

What Does this Mean for People With Lupus?
Other studies have found that living in a poor neighborhood – even if you yourself are not poor – is linked to greater morbidity and mortality. This study did not confirm that to be the case in people with lupus. The authors do conclude, “However, our finding that community poverty is independently associated with increased rates of depressive symptoms suggests that, in this group of individuals facing the challenges of a potentially severe and complex disease, living in a poor community further jeopardizes mental health status.” Because depression is a distinct manifestation of lupus, indeed a symptom of the disease, the risk for a poor outcome is even greater when poverty compounds the situation. The research team will now turn its attention to uncovering the reasons why the combination of personal and community poverty has such an adverse effect on the mental well-being of persons with lupus. One hypothesis to be tested is that neighborhoods with high concentrations of poor people are stressful places to live because of crime rates and poor access to health care professionals.

Trupin L, Tonner MC, Yazdany J, et al. The role of neighborhood and individual socioeconomic status in outcomes of systemic lupus erythematosus. J Rheumatol 2008; e-pub ahead of print July 15.

=========================================================== This information is for"informational purposes" and is not meant to be used for medical diagnosis. Always consult your physician on matters such as this.