What is systemic lupus erythematosus?

Systemic lupus erythematosus (SLE) is most easily recognized by a rash over the cheeks and bridge of the nose. However, this butterfly-shaped rash occurs only in a minority of cases. The disease may cause inflammation of other parts of the body, including other areas of skin, the joints, muscles, kidneys, nervous system, blood, lungs, and heart. Fever, fatigue, and malaise are common. This disease is often just called lupus.

SLE is a serious, chronic disease, which means it never goes away completely. However, there may be symptom-free periods called remissions. Times when symptoms become more severe are called flareups. Some people have severe, even fatal lupus, but for most people symptoms can be controlled.

SLE affects mainly young women, particularly black women in the U.S., West Indian women, and Chinese women.

Cutaneous lupus (also called discoid lupus) is a form of lupus that affects the skin only. It is milder and more common than SLE. The red, thickened, circular patches of rash may be most apparent on uncovered parts of the skin.

How does it occur?

Lupus is an autoimmune disease. This means that the body's defenses against infection attack the body's own tissue. This causes inflammation. Areas of the skin and/or joints become painful, red, and swollen. Other parts of the body can also become inflamed.

The exact cause of lupus is not known. There may be an inherited tendency to develop the disease. Like other autoimmune diseases, attacks of lupus appear to be triggered by particular things, including viral infection and sunlight. Certain drugs may cause some people to have a lupus-like syndrome called drug-induced lupus. Examples of such drugs are hydralazine (used to treat hypertension) and procainamide (used to treat irregular heart rhythms).

What are the symptoms?

SLE can take many forms and does not affect everyone in the same way. Some of the more common symptoms are:

• disk-shaped patches of rash

• joint pain and swollen joints

• fatigue and weakness

• sharp chest pain when you take a deep breath

• fever over 100 degrees F (37.8 degrees C).

How is it diagnosed?

The symptoms of SLE are similar to those of several other inflammatory conditions. It can be difficult to diagnose. Your doctor will examine you carefully. He or she may order blood tests to check for the presence of lupus antibody. Your urine may be tested for extra protein. Less commonly, a skin biopsy is done (a small piece of skin is removed for examination under the microscope).

How is it treated?

There is not yet a cure for SLE, but the symptoms can be treated. Certain medications may be used to ease your discomfort. Nonsteroidal anti-inflammatory drugs (NSAIDs), such as aspirin and ibuprofen, may be prescribed for joint pain and inflammation. Antimalarial drugs may be used to treat more severe joint or skin symptoms. Your doctor may prescribe corticosteroid drugs if your symptoms are especially severe.

Many people with SLE tire easily, but it is not usually necessary to give up your normal activities. Get regular rest when your disease is active and try to avoid stress. During remissions, increase your physical activity to maintain flexibility and muscle strength.

Exposure to the sun can make the skin rashes and other problems of lupus worse. Try to avoid outdoor activities during peak sunlight hours (usually 10 AM to 4 PM). When you are exposed to sunlight, wear a hat to shield your face and clothing that covers your arms, legs, and chest. Always use sunscreen on your skin.

How can I help myself?

• Follow your doctor's recommendations for treating lupus.

• Avoid things that tend to trigger your lupus.

• Discuss all medications you are taking with your doctor, including birth control pills or other medicines containing estrogen. If certain drugs trigger your symptoms, your doctor may prescribe different drugs.

For more information, call or write:

The Lupus Foundation of America
4 Research Place, Suite 180
Rockville, MD 20850-3226
(301) 870-9292, or (800) 558-0121
http://www.lupus.org/lupus

The American Lupus Society
3914 DelAmo Blvd., Suite 922
Torrance, CA 90503
(310) 542-8891