What is the treatment for lupus? What is the usual outcome?
Treatment for lupus targets patient education and control of inflammation. Patients are made to understand that lupus requires rest and proper evening sleep, avoidance of stress, avoidance of sun exposure and regular follow-up with the doctor. The rheumatologists do this, as well as several “lupus clubs” that have sprung up in the country – Manila, Iloilo, Bacolod, Cebu, Cagayan de Oro and Davao.
Anti-inflammatory drugs, both steroids and non-steroids, are used, and may be maintained for extended periods. The rheumatologist uses additional important medicines for its control.
Proper, early, and aggressive treatment for lupus improves outcome that is quantified as 90% survival in ten years. The new treatment methods from ongoing researches using targeted methods (controlling the abnormal part of the defense system) promises to raise this outlook. Among Filipinos, infection is still the leading cause of frequent hospital admissions and even death – which is expected of an abnormal defense system that is unable to fight bacteria and viruses, as well as of treatment, that also dampens the activity of the same. A critical balance is usually achieved in the hands of a specialist, and therefore, the general outlook for lupus has tremendously improved.
SLE can be felt as fever and fatigue for several months accompanied by pain and swelling of the joints, as well as rashes over the cheeks and sun exposed parts of the body. In its worst presentation, the patient can come pale and weak, with edema, headache, convulsions and even strokes. Since it is most common in young to middle-aged females who are in the working and reproductive age, lupus is a major cause of disability and economic burden to individual families and the health system of the country.
Lupus symptoms are common to other conditions, too, which can make diagnosis difficult. Common lupus symptoms include:
- Constant fatigue
- Achy joints
- A butterfly-shaped rash around the cheeks and nose
- Hair loss
- Blood clots
- Sensitivity to light
- Chest pain when breathing
- Mouth sores
- Swelling in the extremities or around the eyes
How is lupus diagnosed?
The diagnosis of lupus is made when a young or middle-aged female comes with many inflamed body parts – arthritis, skin lesions (rashes in the faces, sensitivity to sun exposure), ulcers in the mouth, edema around the ankles and legs, and usually prolonged fever. The patient can be pale and weak-looking. She is usually mistaken for someone with infection, but over time, treatment for infections does not relieve symptoms. A helpful blood examination, ANA, strengthens the diagnosis of lupus. While it is rare in males, symptoms are similar to those in females and should warn the patient and physician of the possibility of lupus.
A tell-tale sign of lupus is a butterfly-shaped rash across the cheeks and bridge of the nose. Derived from the Latin word ‘mala’ which means cheekbone, the Malar or Butterfly rash is a kind of skin condition typically characterized by the appearance of rashes across the cheekbones and over the bridge of the nose. These rashes are usually red or purple in color in either a blotchy pattern or completely red over the affected area, and can be flat or raised in nature. The rash can be mild or severe but is not usually painful. It can be itchy if it is more like a rash than a blush and some patients even report a ‘hot’ feeling with more severe malar rashes.
It is called the lupus butterfly rash because of its butterfly-like shape. Because this particular Malar rash is typical in those suffering from SLE (systemic lupus erythematosus), but even then in only around 40% of patients, it is the primary reason that most lupus organizations have the butterfly as their symbol.
What is Systemic Lupus Erythematosus (SLE; lupus)?
SLE is a lifelong disease wherein the individual’s defense system attacks various parts of the body leading to pain and disease, and if left untreated, death. The organs most often affected are the brain, heart, lungs, liver, kidneys, blood vessels, joints, the tissues and the skin and the overall nervous system.
Despite decades of research, the exact cause of lupus is still unknown. Inherited traits and many environmental triggers such as sunlight, physical, mental and emotional stress, hormones, diet, medications, and infections, have been speculated to create the proper setting for the disease.
It occurs in around 30-50/100,000 populationi and with a July 2011 estimate of 102 million people in the Philippinesii, close to 40,000 of the country’s population probably suffer from SLE.
Both men and women can be affected with lupus, but it is predominately found in women between the child-bearing ages of 15-44, although children and elderly can also have lupus. It is also more common in women or African American, Asian, and Latino decent.
Osio-Salido E, Manapat-Reyes H. Epidemiology of systemic lupus erythematosus in Asia. Lupus October 2010 vol. 19 no. 12 1365-1373
Mollysfund.org. Retrieved from: http://www.mollysfund.org/2012/11/the-lupus-butterfly-rash-or-malar-rash-information-you-need-to-know/