It is estimated that around 20,000 Australians have lupus, but unfortunately not much is known about the disease.
Lupus is a chronic autoimmune disease in which the body’s immune system attacks healthy tissue. As with many autoimmune diseases, Lupus can range in severity from mild to life-threatening.
If anyone has ever watched House, you’ll know how difficult it is to diagnose lupus, but, although there’s no cure, it can typically be managed with medicine and lifestyle changes.
Sometimes, lupus symptoms only affect the skin, but more often it causes internal problems such as joint pain. In severe cases, it can even damage the heart, kidneys, and other vital organs.
Different types of lupus
Systemic lupus erythematosus (SLE) is the most common type of lupus. It can affect any part of the body, but most commonly affects the skin, joints, kidneys, and brain.
Discoid lupus erythematosus (DLE) is generally a milder form of lupus that only affects the skin. It is characterised by a rash that appears on the face, scalp, or ears. Subacute cutaneous lupus is similar, but milder still.
Drug-induced lupus erythematosus (DIL) is a form of lupus that is caused by certain medications. It usually goes away when the person stops taking the medication.
Finally, neonatal lupus erythematosus (NLE) is a rare form of lupus that can affect newborn babies. It is caused by antibodies from the mother that cross the placenta and enter the baby’s bloodstream.
Read: Why autoimmune diseases are on the rise around the globe
What are the symptoms of lupus?
No two cases of lupus are the same, symptoms can be vague, hard to explain and unpredictable. The broad range of symptoms can vary from person to person, which is why it’s so hard to diagnose.
Some people have relatively few symptoms after the initial flare-up, while others have periods of fairly good health (known as remission) alternating with flare-ups of the disease.
Lupus can seriously affect physical and emotional wellbeing. Some of the symptoms include:
- joint pain, stiffness, or swelling
- muscle pain
- fatigue
- skin rashes and lesions
- hair loss
- mouth and nose ulcers
- chest pain (from inflammation of the lining of the heart and lungs)
- anaemia
- poor kidney function
- seizures or visual disturbances
- fever.
Joint pain
Joint and muscle pain is often the first sign of lupus and is experienced by around 50 per cent of sufferers. The pain tends to show up on both sides of the body at the same time and commonly affects the wrists, hands, fingers, and knees. The joints may look inflamed and feel warm to the touch.
Skin rashes and lesions
Skin rashes that appear or worsen after sun exposure are experienced by around one in five people with lupus. A butterfly-shaped rash that appears across the cheeks and nose is often a telltale sign of the disease.
Other common skin problems include sensitivity to the sun with flaky, red spots or a scaly, purple rash on various parts of the body, including the face, neck, and arms. Some people also develop mouth sores.
Changes to nails
Lupus can cause the nails to become discoloured with blue or reddish spots in the nail bed. This discolouration is the result of inflamed small blood vessels. Swelling may also make the skin around the base of the nail look red and puffy. Nails can also crack easily or fall off completely.
Read: What your nails say about you
Light sensitivity
Many people with lupus are unusually sensitive to the sun and other forms of ultraviolet light. A day out in the sun may trigger a skin rash in areas exposed to sunlight and may worsen other lupus symptoms. Adding to this, certain medications can make people with lupus even more sensitive to UV light.
How is lupus diagnosed?
The first flare-up of lupus can often be misdiagnosed as rheumatoid arthritis, which causes joint pain and swelling, or fibromyalgia, which causes fatigue and pain.
One aspect that sets lupus apart is the combination of skin rashes with joint pain and fatigue. Although there is no one blood test for lupus, there are tests that can help distinguish lupus from other diseases.
A blood test for antinuclear antibodies (ANAs) can provide a critical clue. Other lab tests may check cell counts, kidney function, and clotting time. A tissue biopsy of an involved organ such as the skin or kidneys sometimes helps with diagnosis.
Self-care treatments for lupus
Making some changes to your routine may help reduce lupus flare-ups. Try to:
- cover up when in the sun
- avoid smoking
- exercise regularly
- improve stress management skills.
Also, be sure to get plenty of rest. Some people with lupus need up to 12 hours of sleep a night.
Other treatment options
Treatment options may vary according to the diagnosis, but can include prescription medicines and injections. These include corticosteroid creams for rashes and non-steroidal anti-inflammatory drugs (NSAIDs) for joint pain and fever. Antimalarial medications can help fight joint pain, ulcers, and rashes. Corticosteroids may also be given as pills. In severe cases, they can be given intravenously. People with severe lupus may benefit from drugs that suppress the immune system.
To seek help, visit your GP who may refer you to a specialist, such as a rheumatologist, dermatologist or immunologist.
Read: Seven medical reasons why you might be feeling tired all the time
Outlook for lupus
Thanks to improvements in treatments for lupus, people with the condition are living longer and enjoying a better quality of life. While the outlook for any given individual depends on how severe the disease is, and whether any vital organs are affected, most people with lupus can expect to live a normal or nearly normal life span.
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Disclaimer: This article contains general information about health issues and is not advice. For health advice, consult your medical practitioner.
