Systemic lupus erythematosus (SLE). Manifestations and methods of treatment for systemic lupus erythematosus in adults and children

Lupus erythematosus is one of the diffuse connective tissue diseases. Several clinical forms are united under a common name. From this article you can learn about the symptoms of lupus erythematosus, the causes of its development, as well as the basic principles of treatment.

Mostly women are affected. It usually manifests between the ages of 20 and 40. It is more common in countries with a humid maritime climate and cold winds, while in the tropics the incidence is low. Blondes are more susceptible to the disease than brunettes and dark-skinned people. Common symptoms include sensitivity to ultraviolet radiation, vascular rashes on the skin (erythema) and mucous membranes (enanthema). A characteristic symptom is an erythematous butterfly-shaped rash on the face.

Classification

There is currently no unified classification, and all existing ones are very conditional. There is a common division into two types: skin - relatively benign, without damage to internal organs; systemic - severe, in which the pathological process extends not only to the skin and joints, but also to the heart, nervous system, kidneys, lungs, etc. Among the skin forms, chronic discoid (limited) and chronic disseminated (with many foci) are distinguished. Cutaneous lupus erythematosus can be superficial (centrifugal erythema of Biette) or deep. In addition, there is drug-induced lupus syndrome.

Systemic lupus erythematosus can be acute, subacute and chronic, according to the phase of activity - active and inactive, the degree of activity - high, moderate, minimal. Cutaneous forms can transform into systemic forms. Some experts tend to believe that this is one disease that occurs in two stages:

• presystemic - discoid and other skin forms;
• generalization - systemic lupus erythematosus.

Why does it occur?

The reasons still remain unknown. The disease is an autoimmune disease and develops as a result of the formation of a large number of immune complexes that are deposited in healthy tissues and damage it.

Provoking factors include certain infections, medications, chemicals, coupled with hereditary predisposition. There is drug-induced lupus syndrome, which develops as a consequence of taking certain medications and is reversible.

Discoid lupus erythematosus

Symptoms of this form of the disease appear gradually. First, a characteristic (butterfly-shaped) erythema appears on the face. The rashes are localized on the nose, cheeks, forehead, on the red border of the lips, in the scalp, on the ears, less often on the back surfaces of the legs and arms, and the upper body. The red border of the lips can be affected in isolation; rash elements rarely appear on the oral mucosa. Skin manifestations are often accompanied by joint pain. Discoid lupus, the symptoms of which appear in the following sequence: erythematous rash, hyperkeratosis, atrophic phenomena, goes through three stages of development.

The first is called erythematous. During this period, a pair of clearly defined pink spots with a vascular network in the center is formed, and slight swelling is possible. Gradually, the elements increase in size, merge and form foci that are shaped like a butterfly: its “back” is on the nose, its “wings” are located on the cheeks. There may be tingling and burning sensations.

The second stage is hyperkeratotic. It is characterized by infiltration of the affected areas; dense plaques, covered with small whitish scales, appear at the site of the lesions. If you remove the scales, you will find an area underneath that resembles a lemon peel. Subsequently, keratinization of the elements occurs, around which a red rim is formed.

The third stage is atrophic. As a result of cicatricial atrophy, the plaque takes on the appearance of a saucer with a white area in the center. The process continues to progress, the lesions increase in size, and new elements appear. In each lesion, three zones can be found: in the center there is an area of ​​cicatricial atrophy, then there is hyperkeratosis, and at the edges there is redness. In addition, pigmentation and telangiectasia (small dilated vessels, or spider veins) are observed.

Less commonly, the ears, oral mucosa, and scalp are affected. At the same time, comedones appear on the nose and ears, and the mouths of the follicles expand. After the lesions resolve, areas of baldness remain on the head, which is associated with scar atrophy. Cracks, swelling, thickening are observed on the red border of the lips, and keratinization of the epithelium and erosion are observed on the mucous membrane. When the mucous membrane is damaged, pain and burning appear, which intensify when talking or eating.

With lupus erythematosus of the red border of the lips, several clinical forms are distinguished, including:

• Typical. It is characterized by oval-shaped foci of infiltration or the spread of the process to the entire red border. The affected areas become purple in color, the infiltrate is pronounced, and the vessels are dilated. The surface is covered with whitish scales. If they are separated, pain and bleeding occurs. In the center of the lesion there is an area of ​​atrophy, along the edges there are areas of epithelium in the form of white stripes.
• No significant atrophy. Hyperemia and keratotic scales appear on the red border. Unlike the typical form, the scales peel off quite easily, hyperkeratosis is mild, telangiectasia and infiltration, if observed, are insignificant.
• Erosive. In this case, there is quite severe inflammation, the affected areas are bright red, swelling, cracks, erosions, and bloody crusts are observed. Along the edges of the elements there are scales and areas of atrophy. These symptoms of lupus are accompanied by burning, itching and pain, which intensifies when eating. After resolution, scars remain.
• Deep. This form is rare. The affected area has the appearance of a nodular formation rising above the surface with hyperkeratosis and erythema on top.

Lupus erythematosus on the lips is often accompanied by secondary glandular cheilitis.

Much less often, the pathological process develops on the mucous membrane. It is localized, as a rule, on the mucous membranes of the cheeks, lips, and sometimes on the palate and tongue. There are several forms, including:

• Typical. It manifests itself as foci of hyperemia, hyperkeratosis, and infiltration. In the center there is an area of ​​atrophy, along the edges there are areas of white stripes reminiscent of a picket fence.
• Exudative-hyperemic is characterized by severe inflammation, while hyperkeratosis and atrophy are not too pronounced.
• In case of injuries, the exudative-hyperemic form can turn into an erosive-ulcerative form with painful elements around which diverging white stripes are localized. After healing, scars and cords most often remain. This variety has a tendency to become malignant.

Treatment of discoid lupus erythematosus

The main principle of treatment is hormonal agents and immunosuppressants. Certain medications are prescribed depending on the symptoms of lupus erythematosus. Treatment usually lasts several months. If the rash elements are small, corticosteroid ointment should be applied to them. For severe rashes, corticosteroids and immunosuppressants must be taken orally. Since sun rays aggravate the disease, you should avoid exposure to the sun, and if necessary, use a cream that protects against ultraviolet radiation. It is important to start treatment on time. This is the only way to avoid scars or reduce their severity.

Systemic lupus erythematosus: symptoms, treatment

This serious disease has an unpredictable course. Just recently, two decades ago, it was considered fatal. Women get sick much more often than men (10 times). The inflammatory process can begin in any tissues and organs where there is connective tissue. It occurs in both mild form and severe form, leading to disability or death. The severity depends on the variety and quantity of antibodies formed in the body, as well as on the organs involved in the pathological process.

Symptoms of SLE

Systemic lupus is a disease with varied symptoms. It occurs in acute, subacute or chronic forms. It may begin suddenly with a rise in temperature, the appearance of general weakness, weight loss, pain in the joints and muscles. Most have skin manifestations. As with discoid lupus, a characteristic erythema in the form of a clearly defined butterfly forms on the face. The rash can spread to the neck, upper chest, scalp, and limbs. Nodules and spots may appear on the fingertips, and mild erythema and atrophy may appear on the soles and palms. Dystrophic phenomena occur in the form of bedsores, hair loss, and deformation of nails. Erosions, blisters, and petechiae may appear. In severe cases, the blisters open and areas with erosive and ulcerative surfaces form. The rash may appear on the lower legs and around the knee joints.

Systemic lupus erythematosus occurs with lesions of many internal organs and systems. In addition to skin syndrome, muscle and joint pain, diseases of the kidneys, heart, spleen, liver, as well as pleurisy, pneumonia, anemia, thrombocytopenia, and leukopenia may develop. In 10% of patients the spleen is enlarged. In young people and children, enlarged lymph nodes are possible. There are cases of damage to internal organs without skin symptoms. Severe forms can be fatal. The main causes of death are chronic renal failure and sepsis.

If systemic lupus erythematosus occurs in a mild form, the symptoms are the following: rash, arthritis, fever, headache, minor damage to the lungs and heart. If the course of the disease is chronic, then exacerbations are replaced by periods of remission, which can last for years. In severe cases, serious damage to the heart, lungs, kidneys, as well as vasculitis, significant changes in the composition of the blood, and severe disruption of the central nervous system are observed.

The changes that occur in SLE are very diverse, the process of generalization is pronounced. These changes are especially noticeable in subcutaneous fat, intermuscular and periarticular tissues, vascular walls, kidneys, heart, and immune system organs.

All changes can be divided into five groups:

• dystrophic and necrotic in connective tissue;
• inflammation of varying intensity in all organs;
• sclerotic;
• in the immune system (clusters of lymphocytes in the spleen, bone marrow, lymph nodes);
• nuclear pathologies in the cells of all tissues and organs.

Manifestations of SLE

During the course of the disease, a polysyndromic picture develops with manifestations typical for each syndrome.

Skin signs

Skin symptoms of lupus vary and are usually of primary importance in diagnosis. They are absent in approximately 15% of patients. In a quarter of patients, changes in the skin are the first sign of the disease. In about 60% they develop at various stages of the disease.

Lupus erythematosus is a disease whose symptoms can be specific and nonspecific. In total, there are about 30 types of skin manifestations - from erythema to bullous rashes.

The skin form is distinguished by three main clinical signs: erythema, follicular keratosis, and atrophy. Discoid lesions are observed in a quarter of all patients with SLE, and they are characteristic of the chronic form.

Lupus erythematosus is a disease whose symptoms have their own characteristics. The typical shape of erythema is a butterfly shape. Localization of rashes is exposed parts of the body: face, scalp, neck, upper chest and back, limbs.

Centrifugal erythema of Biette (superficial form of CV) has only one of the triad of signs - hyperemia, and the layer of scales, atrophy and scarring are absent. The lesions are usually localized on the face and most often have a butterfly shape. The rashes in this case resemble psoriatic plaques or have the appearance of a ring-shaped rash without scarring.

In a rare form - deep Kaposi-Irgang lupus erythematosus - both typical foci and mobile dense nodes are observed, sharply limited and covered with normal skin.

The cutaneous form occurs continuously over a long period of time, worsening in the spring and summer due to sensitivity to ultraviolet radiation. Changes in the skin are usually not accompanied by any sensations. Only lesions located on the oral mucosa are painful during eating.

Erythema in systemic lupus erythematosus can be limited or confluent, varying in size and shape. As a rule, they are swollen and have a sharp border with healthy skin. Among the skin manifestations of SLE are lupus cheilitis (hyperemia with grayish scales, with erosions, crusts and atrophy on the red border of the lips), erythema on the pads of the fingers, soles, palms, and erosions in the oral cavity. Characteristic symptoms of lupus are trophic disorders: constant dry skin, diffuse alopecia, fragility, thinning and deformation of nails. Systemic vasculitis is manifested by ulcers on the legs, atrophic scarring of the nail bed, gangrene of the fingertips. 30% of patients develop Raynaud's syndrome, characterized by such symptoms as cold hands and feet, goosebumps. Lesions of the mucous membranes of the nasopharynx, oral cavity, and vagina are observed in 30% of patients.

The disease lupus erythematosus has skin symptoms and is more rare. These include bullous, hemorrhagic, urticarial, nodular, papulonecrotic and other types of rashes.

Joint syndrome

Joint lesions are observed in almost all patients with SLE (more than 90% of cases). It is these symptoms of lupus that force a person to see a doctor. One joint or several may hurt; the pain is usually migrating, lasting several minutes or several days. Inflammatory phenomena develop in the wrist, knee and other joints. Morning stiffness is pronounced, the process is most often symmetrical. Not only the joints are affected, but also the ligamentous apparatus. In the chronic form of SLE, which primarily affects joints and periarticular tissues, limited mobility may be irreversible. In rare cases, bone erosions and joint deformities may occur.

Myalgia is found in approximately 40% of patients. Focal myositis, which is characterized by muscle weakness, rarely develops.

There are known cases of aseptic bone necrosis in SLE, and in 25% of cases this is a lesion of the femoral head. Aseptic necrosis can be caused by both the disease itself and high doses of corticosteroids.

Pulmonary manifestations

In 50-70% of patients with SLE, pleurisy (effusion or dry) is diagnosed, which is considered an important diagnostic sign for lupus. With a small amount of effusion, the disease proceeds unnoticed, but massive effusions also occur, in some cases requiring a puncture. Pulmonary pathologies in SLE are usually associated with classical vasculitis and are its manifestation. Often, during an exacerbation and involvement of other organs in the pathological process, lupus pneumonitis develops, characterized by shortness of breath, dry cough, chest pain, and sometimes hemoptysis.

With antiphospholipid syndrome, pulmonary embolism (PE) may develop. In rare cases - pulmonary hypertension, pulmonary hemorrhages, fibrosis of the diaphragm, which is fraught with pulmonary dystrophy (reduction in total lung volume).

Cardiovascular manifestations

Most often, pericarditis develops with lupus erythematosus - up to 50%. As a rule, it is dry, although cases with significant effusion are not excluded. With a long course of SLE and recurrent pericarditis, even dry, large adhesions are formed. In addition, myocarditis and endocarditis are often diagnosed. Myocarditis is manifested by arrhythmias or dysfunction of the heart muscle. Endocarditis is complicated by infectious diseases and throboembolism.

Of the vessels in SLE, medium and small arteries are usually affected. Such disorders as erythematous rashes, digital capillaritis, livedo reticularis (marbled skin), necrosis of the fingertips are possible. Among venous lesions, thrombophlebitis associated with vasculitis is not uncommon. The coronary arteries are often involved in the pathological process: coronaritis and coronary atherosclerosis develop.

One of the causes of death in long-term SLE is myocardial infarction. There is a relationship between coronary artery disease and hypertension, so if high blood pressure is detected, immediate treatment is required.

Manifestations from the gastrointestinal tract

Lesions of the digestive system in SLE are observed in almost half of patients. In this case, systemic lupus has the following symptoms: lack of appetite, nausea, heartburn, vomiting, abdominal pain. The examination reveals impaired motility of the esophagus, its dilatation, ulceration of the mucous membrane of the stomach, esophagus, duodenum, ischemia of the gastric and intestinal walls with perforation, arteritis, and degeneration of collagen fibers.

Acute pancreatitis is diagnosed quite rarely, but it significantly worsens the prognosis. Liver pathologies include both slight enlargement and severe hepatitis.

Renal syndrome

Lupus nephritis develops in 40% of patients with SLE, which is caused by the deposition of immune complexes in the glomeruli. There are six stages of this pathology:

• minimal change disease;
• benign mesangial glomerulonephritis;
• focal proliferative glomerulonephritis;
• diffuse proliferative glomerulonephritis (after 10 years, 50% of patients develop chronic renal failure);
• slowly progressive membranous nephropathy;
• glomerulosclerosis is the final stage of lupus nephritis with irreversible changes in the renal parenchyma.

If systemic lupus erythematosus has renal symptoms, then most likely we need to talk about a poor prognosis.

Nervous system lesions

In 10% of patients with SLE, cerebral vasculitis develops with such manifestations as fever, epileptic seizures, psychosis, coma, stupor, meningism.

Systemic lupus has symptoms associated with mental disorders. Most patients experience a decrease in memory, attention, and mental performance.

Possible damage to the facial nerves, development of peripheral neuropathy and transverse myelitis. Migraine-like headaches associated with damage to the central nervous system are not uncommon.

Hematological syndrome

In SLE, hemolytic anemia, autoimmune thrombocytopenia, and lymphopenia may develop.

Antiphospholipid syndrome

This symptom complex was first described in SLE. Manifested by thrombocytopenia, ischemic necrosis, Libman-Sachs endocarditis, strokes, pulmonary embolism, livedovasculitis, thrombosis (arterial or venous), gangrene.

Drug-induced lupus syndrome

About 50 drugs can cause it, including: Hydralazine, Isoniazid, Procainamide.

Manifested by myalgia, fever, arthralgia, arthritis, anemia, serositis. The kidneys are rarely affected. The severity of symptoms is directly dependent on the dosage. Men and women get sick equally often. The only treatment is drug withdrawal. Sometimes aspirin and other non-steroidal anti-inflammatory drugs are prescribed. Corticosteroids may be indicated in extreme cases.

SLE treatment

It is difficult to talk about the prognosis, since the disease is unpredictable. If treatment began on time and the inflammation was quickly suppressed, then the long-term prognosis may be favorable.

Medicines are selected taking into account the symptoms of systemic lupus. Treatment depends on the severity of the disease.

In the case of a mild form, drugs that reduce skin and joint manifestations are indicated, for example, Hydroxychloroquine, Quinacrine and others. To relieve joint pain, non-steroidal anti-inflammatory drugs may be prescribed, although not all doctors approve of taking NSAIDs for lupus erythematosus. In case of increased blood clotting, aspirin is prescribed in small doses.

In severe cases, it is necessary to start taking medications with prednisolone (Metipred) as soon as possible. The dosage and duration of treatment depend on which organs are affected. To suppress the autoimmune reaction, immunosuppressants are prescribed, for example, Cyclophosphomide. For vasculitis and severe damage to the kidneys and nervous system, complex treatment is indicated, including the use of corticosteroids and immunosuppressants.

After the inflammatory process is suppressed, the rheumatologist determines the dose of prednisolone for long-term use. If the test results have improved, the symptoms have decreased, the doctor gradually reduces the dose of the medicine, but the patient may experience an exacerbation. Nowadays, it is possible to reduce the dosage of the drug for most patients with systemic lupus erythematosus.

If the disease develops as a result of taking medications, then recovery occurs after discontinuation of the drug, sometimes after several months. No special treatment is required.

Features of the disease in women, men and children

As mentioned earlier, women are more susceptible to the disease. There is no consensus on who has more severe symptoms of lupus erythematosus - women or men. There is an assumption that in men the disease is more severe, the number of remissions is less, and the generalization of the process is faster. Some researchers have concluded that thrombocytopenia, renal syndrome and central nervous system lesions in SLE are more common in men, and articular symptoms of lupus erythematosus are more common in women. Others did not share this opinion, and some did not find any gender differences in the development of certain syndromes.

Symptoms of lupus erythematosus in children are characterized by polymorphism at the onset of the disease, and only 20% have monoorgan forms. The disease develops in waves, with alternating periods of exacerbations and remissions. Lupus erythematosus in children is characterized by an acute onset, rapid progression, early generalization and a worse prognosis than in adults. Symptoms at the onset of the disease are fever, malaise, weakness, poor appetite, weight loss, rapid hair loss. In the systemic form, manifestations are as varied as in adults.

This disease is accompanied by disruption of the immune system, resulting in inflammation of the muscles, other tissues and organs. Lupus erythematosus occurs with periods of remission and exacerbation, and the development of the disease is difficult to predict; As the disease progresses and new symptoms appear, the disease leads to the formation of failure of one or more organs.

What is lupus erythematosus

This is an autoimmune pathology that affects the kidneys, blood vessels, connective tissues and other organs and systems. If, under normal conditions, the human body produces antibodies that can attack foreign organisms entering from the outside, then in the presence of a disease, the body produces a large number of antibodies to the body’s cells and their components. As a result, an immune complex inflammatory process is formed, the development of which leads to dysfunction of various elements of the body. Systemic lupus affects internal and external organs, including:

• lungs;
• kidneys;
• skin;
• heart;
• joints;
• nervous system.

Causes

The etiology of systemic lupus still remains unclear. Doctors suggest that the cause of the disease is viruses (RNA, etc.). In addition, a risk factor for the development of pathology is a hereditary predisposition to it. Women suffer from lupus erythematosus about 10 times more often than men, which is explained by the characteristics of their hormonal system (there is a high concentration of estrogen in the blood). The reason why the disease occurs less frequently in men is the protective effect of androgens (male sex hormones). The following may increase the risk of SLE:

• bacterial infection;
• taking medications;
• viral infection.

Development mechanism

A normally functioning immune system produces substances to fight antigens of any infections. In systemic lupus, antibodies deliberately destroy the body's own cells, and they cause absolute disorganization of connective tissue. Typically, patients exhibit fibroid changes, but other cells are susceptible to mucoid swelling. In the affected structural units of the skin, the core is destroyed.

In addition to damage to skin cells, plasma and lymphoid particles, histiocytes, and neutrophils begin to accumulate in the walls of blood vessels. Immune cells settle around the destroyed nucleus, which is called the “rosette” phenomenon. Under the influence of aggressive complexes of antigens and antibodies, lysosome enzymes are released, which stimulate inflammation and lead to damage to connective tissue. New antigens with antibodies (autoantibodies) are formed from destruction products. As a result of chronic inflammation, tissue sclerosis occurs.

Forms of the disease

Depending on the severity of the symptoms of the pathology, the systemic disease has a certain classification. Clinical types of systemic lupus erythematosus include:

1. Acute form. At this stage, the disease progresses sharply, and the patient’s general condition worsens, while he complains of constant fatigue, high temperature (up to 40 degrees), pain, fever and muscle aches. The symptoms of the disease develop quickly, and within a month it affects all human tissues and organs. The prognosis for the acute form of SLE is not comforting: often the life expectancy of a patient with such a diagnosis does not exceed 2 years.
2. Subacute form. It may take more than a year from the onset of the disease to the onset of symptoms. This type of disease is characterized by frequent alternation of periods of exacerbation and remission. The prognosis is favorable, and the patient’s condition depends on the treatment chosen by the doctor.
3. Chronic. The disease is sluggish, the symptoms are mild, the internal organs are practically undamaged, so the body functions normally. Despite the mild course of the pathology, it is virtually impossible to cure it at this stage. The only thing that can be done is to alleviate a person’s condition with the help of medications during an exacerbation of SLE.

It is necessary to distinguish between skin diseases related to lupus erythematosus, but which are not systemic and do not have generalized lesions. Such pathologies include:

• discoid lupus (a red rash on the face, head, or other parts of the body that is slightly raised above the skin);
• drug-induced lupus (inflammation of the joints, rash, high fever, pain in the sternum associated with taking medications; symptoms go away after they are discontinued);
• neonatal lupus (rarely expressed, affects newborns when mothers have diseases of the immune system; the disease is accompanied by liver abnormalities, skin rashes, and heart pathologies).

How does lupus manifest?

The main symptoms of SLE include severe fatigue, skin rash, and joint pain. As the pathology progresses, problems with the functioning of the heart, nervous system, kidneys, lungs, and blood vessels become relevant. The clinical picture of the disease in each specific case is individual, since it depends on which organs are affected and what degree of damage they have.

On the skin

Tissue damage appears at the onset of the disease in approximately a quarter of patients; in 60-70% of patients with SLE, the skin syndrome is noticeable later, and in the rest it does not occur at all. As a rule, the localization of the lesion is characterized by areas of the body exposed to the sun - the face (butterfly-shaped area: nose, cheeks), shoulders, neck. The lesions are similar to erythematosus in that they appear as red, scaly plaques. At the edges of the rash there are dilated capillaries and areas with excess/lack of pigment.

In addition to the face and other areas of the body exposed to sunlight, systemic lupus affects the scalp. As a rule, this manifestation is localized in the temporal region, with hair falling out in a limited area of ​​the head (local alopecia). In 30-60% of SLE patients, increased sensitivity to sunlight (photosensitivity) is noticeable.

In the kidneys

Very often, lupus erythematosus affects the kidneys: in about half of patients, damage to the renal apparatus is determined. A common symptom of this is the presence of protein in the urine; casts and red blood cells are usually not detected at the onset of the disease. The main signs that SLE has affected the kidneys are:

• membranous nephritis;
• proliferative glomerulonephritis.

In the joints

Rheumatoid arthritis is often diagnosed with lupus: in 9 out of 10 cases it is non-deforming and non-erosive. More often the disease affects the knee joints, fingers, and wrists. In addition, patients with SLE sometimes develop osteoporosis (low bone density). Patients often complain of muscle pain and muscle weakness. Immune inflammation is treated with hormonal medications (corticosteroids).

On mucous membranes

The disease manifests itself on the mucous membrane of the oral cavity and nasopharynx in the form of ulcers that do not cause pain. Damage to the mucous membranes is recorded in 1 out of 4 cases. This is typical for:

• decreased pigmentation, red border of the lips (cheilitis);
• ulcerations of the oral cavity/nasal cavity, pinpoint hemorrhages.

On vessels

Lupus erythematosus can affect all structures of the heart, including the endocardium, pericardium and myocardium, coronary vessels, and valves. However, damage to the outer lining of the organ occurs more often. Diseases that can result from SLE:

• pericarditis (inflammation of the serous membranes of the heart muscle, manifested by dull pain in the chest area);
• myocarditis (inflammation of the heart muscle, accompanied by disturbances in rhythm, nerve impulse conduction, acute/chronic organ failure);
• heart valve dysfunction;
• damage to the coronary vessels (can develop at an early age in patients with SLE);
• damage to the inside of blood vessels (this increases the risk of developing atherosclerosis);
• damage to the lymphatic vessels (manifested by thrombosis of the extremities and internal organs, panniculitis - painful subcutaneous nodes, livedo reticularis - blue spots forming a mesh pattern).

On the nervous system

Doctors suggest that the failure of the central nervous system is caused by damage to the blood vessels of the brain and the formation of antibodies to neurons - cells that are responsible for nourishing and protecting the organ, as well as to immune cells (lymphocytes. The key signs that the disease has affected the nervous structures of the brain are :

• psychosis, paranoia, hallucinations;
• migraine, headaches;
• Parkinson's disease, chorea;
• depression, irritability;
• brain stroke;
• polyneuritis, mononeuritis, aseptic meningitis;
• encephalopathy;
• neuropathy, myelopathy, etc.

Symptoms

The systemic disease has an extensive list of symptoms, and is characterized by periods of remission and complications. The onset of pathology can be immediate or gradual. Signs of lupus depend on the form of the disease, and since it belongs to the multiorgan category of pathologies, clinical symptoms can be varied. Mild forms of SLE are limited only to damage to the skin or joints; more severe types of the disease are accompanied by other manifestations. Typical symptoms of the disease include:

• swollen eyes, joints of the lower extremities;
• muscle/joint pain;
• enlarged lymph nodes;
• hyperemia;
• increased fatigue, weakness;
• red, allergic-like rashes on the face;
• causeless fever;
• blueness of fingers, hands, feet after stress, contact with cold;
• alopecia;
• pain when inhaling (indicates damage to the lining of the lungs);
• sensitivity to sunlight.

First signs

Early symptoms include temperature, which fluctuates between 38,039 degrees and can last for several months. After this, the patient develops other signs of SLE, including:

• arthrosis of small/large joints (may go away on its own, and then reappear with greater intensity);
• a butterfly-shaped rash on the face, rashes also appear on the shoulders and chest;
• inflammation of the cervical and axillary lymph nodes;
• In case of severe damage to the body, internal organs - kidneys, liver, heart - suffer, which results in disruption of their functioning.

In children

At an early age, lupus erythematosus manifests itself with numerous symptoms, progressively affecting different organs of the child. At the same time, doctors cannot predict which system will fail next. Primary signs of pathology may resemble common allergies or dermatitis; This pathogenesis of the disease causes difficulties in diagnosis. Symptoms of SLE in children may include:

• dystrophy;
• thinning of the skin, photosensitivity;
• fever accompanied by profuse sweating and chills;
• allergic rashes;
• dermatitis, as a rule, is first localized on the cheeks, bridge of the nose (looks like warty rashes, blisters, swelling, etc.);
• joint pain;
• brittle nails;
• necrosis on the fingertips, palms;
• alopecia, up to complete baldness;
• convulsions;
• mental disorders (nervousness, moodiness, etc.);
• stomatitis that cannot be treated.

Diagnostics

To make a diagnosis, doctors use a system developed by American rheumatologists. To confirm that a patient has lupus erythematosus, the patient must have at least 4 of the 11 listed symptoms:

• erythema on the face in the shape of butterfly wings;
• photosensitivity (pigmentation on the face that worsens when exposed to sunlight or UV radiation);
• discoid rash on the skin (asymmetrical red plaques that peel and crack, with areas of hyperkeratosis having jagged edges);
• symptoms of arthritis;
• formation of ulcers on the mucous membranes of the mouth and nose;
• disturbances in the functioning of the central nervous system - psychosis, irritability, tantrums for no reason, neurological pathologies, etc.;
• serous inflammation;
• frequent pyelonephritis, the appearance of protein in the urine, the development of renal failure;
• false positive reaction of the Wasserman test, detection of titers of antigens and antibodies in the blood;
• reduction of platelets and lymphocytes in the blood, changes in its composition;
• causeless increase in antinuclear antibody levels.

The specialist makes a final diagnosis only if four or more signs from the list are present. When the verdict is in doubt, the patient is referred for a highly focused, detailed examination. When diagnosing SLE, the doctor plays a major role in collecting anamnesis and studying genetic factors. The doctor must find out what diseases the patient had during the last year of life and how they were treated.

Treatment

SLE is a chronic disease in which complete cure of the patient is impossible. The goals of therapy are to reduce the activity of the pathological process, restore and maintain the functionality of the affected system/organs, prevent exacerbations to achieve longer life expectancy for patients and improve their quality of life. Treatment of lupus involves the mandatory use of medications, which are prescribed by the doctor to each patient individually, depending on the characteristics of the body and the stage of the disease.

Patients are hospitalized in cases where they have one or more of the following clinical manifestations of the disease:

• suspicion of stroke, heart attack, severe damage to the central nervous system, pneumonia;
• an increase in temperature above 38 degrees for a long time (the fever cannot be eliminated with the help of antipyretics);
• depression of consciousness;
• a sharp reduction in leukocytes in the blood;
• rapid progression of disease symptoms.

If the need arises, the patient is referred to specialists such as a cardiologist, nephrologist or pulmonologist. Standard treatment for SLE includes:

• hormonal therapy (glucocorticoid drugs are prescribed, for example, Prednisolone, Cyclophosphamide, etc.);
• anti-inflammatory medications (usually Diclofenac in ampoules);
• antipyretics (based on Paracetamol or Ibuprofen).

To relieve burning and peeling of the skin, the doctor prescribes creams and ointments based on hormonal agents to the patient. During the treatment of lupus erythematosus, special attention is paid to maintaining the patient’s immunity. During remission, the patient is prescribed complex vitamins, immunostimulants, and physiotherapeutic manipulations. Drugs that stimulate the immune system, such as Azathioprine, are taken only during the lull of the disease, otherwise the patient’s condition may worsen sharply.

Acute lupus

Treatment should begin in the hospital as early as possible. The therapeutic course should be long and constant (without breaks). During the active phase of the pathology, the patient is given glucocorticoids in large doses, starting with 60 mg of Prednisolone and increasing by another 35 mg over 3 months. Reduce the volume of the drug slowly, switching to tablets. Afterwards, a maintenance dose of medication (5-10 mg) is prescribed individually.

To prevent disturbances in mineral metabolism, potassium preparations (Panangin, potassium acetate solution, etc.) are prescribed simultaneously with hormonal therapy. After completion of the acute phase of the disease, complex treatment with corticosteroids is carried out in reduced or maintenance doses. In addition, the patient takes aminoquinoline medications (1 tablet of Delagin or Plaquenil).

Chronic

The earlier treatment is started, the greater the patient’s chances of avoiding irreversible consequences in the body. Therapy for chronic pathology necessarily includes taking anti-inflammatory drugs, drugs that suppress the activity of the immune system (immunosuppressants) and corticosteroid hormonal drugs. However, only half of patients achieve success in treatment. In the absence of positive dynamics, stem cell therapy is performed. As a rule, there is no autoimmune aggression after this.

Why is lupus erythematosus dangerous?

Some patients with this diagnosis develop severe complications - the functioning of the heart, kidneys, lungs, and other organs and systems is disrupted. The most dangerous form of the disease is systemic, which even damages the placenta during pregnancy, resulting in fetal growth retardation or death. Autoantibodies can cross the placenta and cause neonatal (congenital) disease in the newborn. At the same time, the baby develops a skin syndrome that goes away after 2-3 months.

How long do people live with lupus erythematosus?

Thanks to modern medications, patients can live more than 20 years after diagnosis of the disease. The process of development of pathology occurs at different speeds: in some people, symptoms increase in intensity gradually, in others they increase quickly. Most patients continue to lead their usual lifestyle, but in severe cases of the disease, the ability to work is lost due to severe joint pain, high fatigue, and central nervous system disorders. The duration and quality of life in SLE depends on the severity of symptoms of multiple organ failure.

Video

The susceptibility of women to the disease is several times higher than that of men, which is due to the structural features of the female body. The most critical age for the development of systemic lupus erythematosus (SLE) is considered to be puberty, during pregnancy and a certain interval after it while the body goes through the recovery phase.

In addition, a separate category for the occurrence of pathology is considered to be children over 8 years of age, but this is not a determining parameter, because a congenital type of the disease or its manifestation in early life cannot be excluded.

What kind of disease is this?

Systemic lupus erythematosus (SLE, Libman-Sachs disease) (Latin lupus erythematodes, English systemic lupus erythematosus) is a diffuse connective tissue disease characterized by systemic immunocomplex damage to the connective tissue and its derivatives, with damage to the microvasculature.

A systemic autoimmune disease in which antibodies produced by the human immune system damage the DNA of healthy cells, primarily damaging connective tissue with the obligatory presence of a vascular component. The disease received its name because of its characteristic feature - a rash on the bridge of the nose and cheeks (the affected area is shaped like a butterfly), which, as was believed in the Middle Ages, resembles wolf bites.

Story

Lupus erythematosus gets its name from the Latin words “lupus” - wolf and “erythematosus” - red. This name was given due to the similarity of skin signs with damage after a bite from a hungry wolf.

History of the disease lupus erythematosus began in 1828. This happened after the French dermatologist Biett first described the skin signs. Much later, 45 years later, dermatologist Kaposhi noticed that some patients, along with skin symptoms, have diseases of internal organs.

In 1890 It was discovered by the English doctor Osler that systemic lupus erythematosus can occur without skin manifestations. Description of the phenomenon of LE-(LE) cells is the detection of cell fragments in the blood, in 1948. made it possible to identify patients.

In 1954 Certain proteins were found in the blood of the sick - antibodies that act against their own cells. This finding has been used in the development of sensitive tests for diagnosing systemic lupus erythematosus.

Causes

The causes of the disease have not been fully elucidated. Only putative factors contributing to the occurrence of pathological changes have been identified.

Genetic mutations - a group of genes associated with specific immune disorders and predisposition to systemic lupus erythematosus has been identified. They are responsible for the process of apoptosis (getting rid of dangerous cells from the body). When potential pests are delayed, healthy cells and tissues are damaged. Another way is to disorganize the process of managing immune defense. The reaction of phagocytes becomes excessively strong, does not stop with the destruction of foreign agents, and their own cells are mistaken for “strangers.”

1. Age - systemic lupus erythematosus affects people from 15 to 45 years of age, but there are cases that occur in childhood and in the elderly.
2. Heredity - there are known cases of familial disease, probably transmitted from older generations. However, the risk of having a sick child remains low.
3. Race - American studies have shown that the black population gets sick 3 times more often than whites, and this cause is also more pronounced among indigenous Indians, natives of Mexico, Asians, and Spanish women.
4. Gender - There are 10 times more women than men among known patients, so scientists are trying to establish a connection with sex hormones.

Among external factors, the most pathogenic is intense solar radiation. Tanning can cause genetic changes. There is an opinion that people who are professionally dependent on activities in the sun, frost, or sharp fluctuations in environmental temperature (sailors, fishermen, agricultural workers, builders) are more likely to suffer from systemic lupus.

In a significant proportion of patients, clinical signs of systemic lupus appear during the period of hormonal changes, against the background of pregnancy, menopause, taking hormonal contraceptives, and during intensive puberty.

The disease is also associated with a previous infection, although it is not yet possible to prove the role and degree of influence of any pathogen (targeted work is underway on the role of viruses). Attempts to identify a connection with immunodeficiency syndrome or to establish the contagiousness of the disease have so far been unsuccessful.

Pathogenesis

How does systemic lupus erythematosus develop in a seemingly healthy person? Under the influence of certain factors and reduced function of the immune system, a malfunction occurs in the body, during which antibodies begin to be produced against the “native” cells of the body. That is, tissues and organs begin to be perceived by the body as foreign objects and a self-destruction program is launched.

This reaction of the body is pathogenic in nature, provoking the development of an inflammatory process and inhibition of healthy cells in various ways. Most often, blood vessels and connective tissue are affected by changes. The pathological process leads to a violation of the integrity of the skin, a change in its appearance and a decrease in blood circulation in the lesion. As the disease progresses, internal organs and systems of the entire body are affected.

Classification

Depending on the area affected and the nature of the course, the disease is classified into several types:

1. Lupus erythematosus caused by taking certain drugs. Leads to the appearance of SLE symptoms, which may spontaneously disappear after discontinuation of the drugs. Medicines that can lead to the development of lupus erythematosus include drugs for the treatment of arterial hypotension (arteriolar vasodilators), antiarrhythmics, and anticonvulsants.
2. Systemic lupus erythematosus. The disease tends to progress rapidly, affecting any organ or system of the body. It occurs with fever, malaise, migraines, rashes on the face and body, as well as pain of various types in any part of the body. The most common symptoms are migraines, arthralgia, and kidney pain.
3. Neonatal lupus. Occurs in newborns, often combined with heart defects, serious disorders of the immune and circulatory systems, and liver development abnormalities. The disease is extremely rare; Conservative therapy measures can effectively reduce the manifestations of neonatal lupus.
4. Discoid lupus. The most common form of the disease is centrifugal erythema of Biette, the main manifestations of which are skin symptoms: red rash, thickening of the epidermis, inflamed plaques that transform into scars. In some cases, the disease leads to damage to the mucous membranes of the mouth and nose. A type of discoid is deep Kaposi-Irganga lupus, which is characterized by a recurrent course and deep lesions of the skin. A feature of the course of this form of the disease are signs of arthritis, as well as a decrease in human performance.

Symptoms of lupus erythematosus

Being a systemic disease, lupus erythematosus is characterized by the following symptoms:

• chronic fatigue syndrome;
• swelling and tenderness of the joints, as well as muscle pain;
• unexplained fever;
• chest pain when breathing deeply;
• increased hair loss;
• red, skin rashes on the face or discoloration of the skin;
• sensitivity to the sun;
• swelling, swelling of the legs, eyes;
• swollen lymph nodes;
• blue or white fingers and toes when exposed to cold or stress (Raynaud's syndrome).

Some people experience headaches, cramps, dizziness, and depression.

New symptoms may appear years after diagnosis. In some patients, one system of the body suffers (joints or skin, hematopoietic organs); in other patients, manifestations can affect many organs and be multi-organ in nature. The severity and depth of damage to body systems is different for everyone. The muscles and joints are often affected, causing arthritis and myalgia (muscle pain). Skin rashes are similar in different patients.

If the patient has multiple organ manifestations, then the following pathological changes occur:

• inflammation in the kidneys (lupus nephritis);
• inflammation of blood vessels (vasculitis);
• pneumonia: pleurisy, pneumonitis;
• heart diseases: coronary vasculitis, myocarditis or endocarditis, pericarditis;
• blood diseases: leukopenia, anemia, thrombocytopenia, risk of blood clots;
• damage to the brain or central nervous system, and this provokes: psychosis (change in behavior), headache, dizziness, paralysis, memory impairment, vision problems, convulsions.

What does lupus erythematosus look like, photo

The photo below shows how the disease manifests itself in humans.

The manifestation of symptoms of this autoimmune disease can vary significantly among different patients. However, common areas of localization of lesions, as a rule, are the skin, joints (mainly hands and fingers), heart, lungs and bronchi, as well as digestive organs, nails and hair, which become more fragile and prone to loss, as well as the brain and nervous system.

Stages of the disease

Depending on the severity of the symptoms of the disease, systemic lupus erythematosus has several stages:

1. Acute stage - at this stage of development, lupus erythematosus progresses sharply, the patient’s general condition worsens, he complains of constant fatigue, fever up to 39-40 degrees, fever, pain and aching muscles. The clinical picture develops rapidly; within 1 month the disease covers all organs and tissues of the body. The prognosis for acute lupus erythematosus is not comforting and often the patient’s life expectancy does not exceed 2 years;
2. Subacute stage - the rate of progression of the disease and the severity of clinical symptoms are not the same as in the acute stage, and more than 1 year may pass from the moment of the disease to the onset of symptoms. At this stage, the disease often gives way to periods of exacerbations and stable remission, the prognosis is generally favorable and the patient’s condition directly depends on the adequacy of the prescribed treatment;
3. Chronic form - the disease has a sluggish course, clinical symptoms are mild, internal organs are practically not affected and the body as a whole functions normally. Despite the relatively mild course of lupus erythematosus, it is impossible to cure the disease at this stage; the only thing that can be done is to alleviate the severity of symptoms with the help of medications at the time of exacerbation.

Complications of SLE

The main complications caused by SLE:

1) Heart disease:

• pericarditis - inflammation of the heart sac;
• hardening of the coronary arteries that supply the heart due to the accumulation of thrombotic clots (atherosclerosis);
• endocarditis (infection of damaged heart valves) due to hardening of the heart valves, accumulation of blood clots. Valve transplantation is often performed;
• myocarditis (inflammation of the heart muscle), causing severe arrhythmias, diseases of the heart muscle.

2) Renal pathologies (nephritis, nephrosis) develop in 25% of patients suffering from SLE. The first symptoms are swelling in the legs, the presence of protein and blood in the urine. Failure of the kidneys to work normally is extremely life-threatening. Treatment includes the use of strong drugs for SLE, dialysis, and a kidney transplant.

3) Blood diseases that are life-threatening.

• decrease in red blood cells (supply cells with oxygen), leukocytes (suppress infections and inflammation), platelets (promote blood clotting);
• hemolytic anemia caused by a lack of red blood cells or platelets;
• pathological changes in the hematopoietic organs.

4) Lung diseases (in 30%), pleurisy, inflammation of the chest muscles, joints, ligaments. Development of acute tuberculous lupus (inflammation of lung tissue). Pulmonary embolism is a blockage of arteries by emboli (blood clots) due to increased blood viscosity.

Diagnostics

The assumption of the presence of lupus erythematosus can be made on the basis of red foci of inflammation on the skin. External signs of erythematosis may change over time, so it is difficult to make an accurate diagnosis based on them. It is necessary to use a set of additional examinations:

• general blood and urine tests;
• determination of liver enzyme levels;
• antinuclear body (ANA) analysis;
• chest x-ray;
• echocardiography;
• biopsy.

Differential diagnosis

Chronic lupus erythematosus is differentiated from lichen planus, tuberculous leukoplakia and lupus, early rheumatoid arthritis, Sjogren's syndrome (see dry mouth, dry eye syndrome, photophobia). When the red border of the lips is affected, chronic SLE is differentiated from abrasive precancerous Manganotti cheilitis and actinic cheilitis.

Since damage to internal organs is always similar in course to various infectious processes, SLE is differentiated from Lyme disease, syphilis, mononucleosis (infectious mononucleosis in children: symptoms), and HIV infection.

Treatment of systemic lupus erythematosus

Treatment should be as appropriate as possible for the individual patient.

Hospitalization is necessary in the following cases:

• with a persistent increase in temperature for no apparent reason;
• when life-threatening conditions occur: rapidly progressive renal failure, acute pneumonitis or pulmonary hemorrhage.
• when neurological complications occur.
• with a significant decrease in the number of platelets, red blood cells or lymphocytes.
• in cases where an exacerbation of SLE cannot be treated on an outpatient basis.

For the treatment of systemic lupus erythematosus during an exacerbation, hormonal drugs (prednisolone) and cytostatics (cyclophosphamide) are widely used according to a certain scheme. If the organs of the musculoskeletal system are affected, as well as with an increase in temperature, non-steroidal anti-inflammatory drugs (diclofenac) are prescribed.

For adequate treatment of a disease of a particular organ, consultation with a specialist in this field is necessary.

Nutrition rules

Dangerous and harmful foods for lupus:

• large amounts of sugar;
• everything fried, fatty, salted, smoked, canned;
• products to which there are allergic reactions;
• sweet sodas, energy drinks and alcoholic drinks;
• if you have kidney problems, foods containing potassium are contraindicated;
• canned food, sausages and factory-cooked sausages;
• store-bought mayonnaise, ketchup, sauces, dressings;
• confectionery products with cream, condensed milk, and artificial fillers (factory-made jams, marmalades);
• fast food and products with unnatural fillers, dyes, leavening agents, taste and odor enhancers;
• foods containing cholesterol (buns, bread, red meat, high-fat dairy products, sauces, dressings and soups based on cream);
• products that have a long shelf life (we mean those products that quickly deteriorate, but thanks to various chemical additives in their composition, they can be stored for a very long time - this, for example, includes dairy products with a one-year shelf life).

Eating these foods can speed up the progression of the disease, which can lead to death. These are the maximum consequences. And, at a minimum, the dormant stage of lupus will become active, which will cause all the symptoms to worsen and your health to worsen significantly.

Lifespan

Survival rate 10 years after diagnosis of systemic lupus erythematosus is 80%, after 20 years - 60%. Main causes of death: lupus nephritis, neurolupus, intercurrent infections. There are cases of survival of 25-30 years.

In general, the quality and length of life with systemic lupus erythematosus depends on several factors:

1. Patient's age: the younger the patient, the higher the activity of the autoimmune process and the more aggressive the disease is, which is associated with greater reactivity of the immune system at a young age (more autoimmune antibodies destroy their own tissues).
2. Timeliness, regularity and adequacy of therapy: with long-term use of glucocorticosteroid hormones and other drugs, you can achieve a long period of remission, reduce the risk of complications and, as a result, improve the quality of life and its duration. Moreover, it is very important to start treatment before complications develop.
3. Variant of the course of the disease: the acute course is extremely unfavorable and after a couple of years severe, life-threatening complications may arise. And with a chronic course, which is 90% of cases of SLE, you can live a full life until old age (if you follow all the recommendations of a rheumatologist and therapist).
4. Compliance with the regimen significantly improves the prognosis of the disease. To do this, you need to be constantly monitored by a doctor, adhere to his recommendations, promptly contact doctors if any symptoms of exacerbation of the disease appear, avoid contact with sunlight, limit water procedures, lead a healthy lifestyle and follow other rules for preventing exacerbations.

Just because you've been diagnosed with lupus doesn't mean your life is over. Try to defeat the disease, maybe not in the literal sense. Yes, you will probably be limited in some ways. But millions of people with more severe illnesses live bright, full of impressions lives! So you can too.

Prevention

The goal of prevention is to prevent the development of relapses and to maintain the patient in a state of stable remission for a long time. Prevention of lupus is based on an integrated approach:

• Regular medical examinations and consultations with a rheumatologist.
• Take medications strictly in the prescribed dose and at the specified intervals.
• Compliance with the work and rest regime.
• Get adequate sleep, at least 8 hours a day.
• A diet with limited salt and sufficient protein.
• Hardening, walking, gymnastics.
• The use of hormone-containing ointments (for example, Advantan) for skin lesions.
• Use of sunscreens (creams).

One of the most serious diseases is systemic lupus erythematosus (SLE). It is characterized by autoimmune inflammation with many other symptoms. This disease is dangerous due to its complications. It affects the organs of many body systems, but the most problems occur with the musculoskeletal system and kidneys.

Description of the disease

Lupus develops due to a malfunction of the immune system, in which antibodies are formed that negatively affect healthy cells and tissues. This leads to negative changes in blood vessels and connective tissue.

The term "lupus" was once used to refer to red patches that appeared on the face. They resembled the bites of wolves or she-wolves, which often attacked people and sought to get to unprotected parts of the body, like the nose or cheeks. Even one of the symptoms of the disease is called “lupus butterfly.” Today the name is associated with the cute word “wolf cub”.

Autoimmune disease develops against the background of hormonal disorders. Increased amounts of estrogens play a major role, so lupus is most often observed in the fair sex. The disease is usually diagnosed in teenage girls and young women under 26 years of age.

In men, SLE is more severe, and remissions are rare, but in them the disease is 10 times less common, since androgens have a protective effect. Some symptoms may be more severe in different genders. For example, in women the joints are more affected, and in men the central nervous system and kidneys are more affected.

Lupus can be congenital. Symptoms of SLE appear in children already in the first years of life.

The disease develops in waves, with alternating periods of exacerbations and remissions. SLE is characterized by an acute onset, rapid progression and early spread of the disease process. In children, the symptoms of systemic lupus erythematosus are the same as in adults.

Causes

The occurrence and development of lupus is influenced by more than one reason. It is caused by the simultaneous or sequential influence of several factors. Scientists were able to discover the main causes of the disease:

Scientists do not include the last factor in the common causes of SLE, but they believe that the patient’s relatives are at risk.

Classification by stages

SLE has a wide range of symptoms. During the illness, exacerbations and remissions occur.

Lupus is classified according to its forms:

The stages of the disease are also distinguished. Minimal is characterized by mild headaches and joint pains, high fever, malaise and the first manifestations of lupus on the skin.

In the moderate phase, the face and body are severely affected, and then the blood vessels, joints and internal organs. At an advanced stage, the functioning of various body systems is disrupted.

Symptoms of the disease

At the onset of SLE, skin lesions affect only 20% of patients. In 60% of patients, symptoms appear later. Some people don't experience them at all. Signs of the disease can be seen on the face, neck and shoulders. A rash appears on the back of the nose and cheeks in the form of reddish plaques with peeling, reminiscent of wolf bites in the past. It is called the "lupus butterfly" because it looks like this insect. The patient's skin sensitivity to ultraviolet radiation increases.

Some people with lupus experience hair loss from the temples and broken nails. Mucous membranes are affected in 25% of cases. Lupus cheilitis appears, characterized by dense swelling of the lips in the form of grayish scales. Small red or pink ulcers may appear along the border. In addition, the oral mucosa is affected.

Lupus affects various body systems:

Common symptoms of lupus in women and men are central nervous system lesions. The disease is characterized by rapid fatigue, weakness, decreased memory and performance, and deterioration of intellectual abilities. A person suffering from an autoimmune disease experiences irritability, depression, headaches, etc.

The patient may experience decreased sensitivity. Seizures, psychoses and convulsions also develop against the background of lupus.

Diagnostic methods

The diagnosis of lupus can be confirmed using differential diagnosis. It is done because each manifestation indicates the pathology of a specific organ. For this purpose, a system developed by the American Rheumatological Association of Specialists is used.

The diagnosis of SLE is confirmed with four or more symptoms from this list:

After a preliminary diagnosis has been made, the patient is referred to a specialist with a narrow focus, for example, a nephrologist, pulmonologist or cardiologist.

A detailed examination includes a thorough history taking. The doctor needs to find out about all the patient’s previous diseases and methods of treating them.

Treatment options

Drug therapy for patients with SLE is selected individually. Treatment methods depend on the stage and form of the disease, the symptoms that appear and the characteristics of the patient’s body.

A person suffering from lupus will need to be hospitalized only in certain cases: a constant temperature above 38 degrees, a decrease, and also if a stroke, heart attack or severe damage to the central nervous system is suspected. If the clinical signs of the disease progress, then the patient will also be sent to hospitalization.

Treatment of lupus erythematosus includes:

Hormonal creams and ointments eliminate peeling and burning sensations that occur in certain areas of the skin.

Particular attention is paid to the patient's immune system. During remission, the patient is treated with immunostimulants in combination with vitamin complexes and physiotherapeutic procedures.

Concomitant diseases and complications are also taken into account. Since the first place in cases of mortality is occupied by kidney problems, they must be constantly monitored in SLE. It is necessary to promptly treat lupus arthritis and heart disease.

Dandelion P acts as a natural chondroprotector, which prevents joints from collapsing and restores cartilage tissue. It lowers blood cholesterol and cleanses the body of toxins. Dihydroquercetin Plus is used to strengthen the walls of blood vessels. It also eliminates bad cholesterol and improves blood microcirculation.

People with lupus are prescribed foods to help relieve symptoms of the disease. The patient should give preference to foods that can protect the brain, heart and kidneys.

A person diagnosed with lupus must be consumed in sufficient quantities:

Protein will help fight the disease. Doctors recommend eating veal, turkey and other dietary meats and poultry. The diet should include cod, pollock, pink salmon, tuna, squid, and low-fat herring. Fish contains omega-3 unsaturated fatty acids, which are vital for normal brain and heart function.

You need to drink at least 8 glasses of clean water per day. It improves the functioning of the gastrointestinal tract, controls hunger and improves general condition.

You will need to avoid or limit some foods in your diet:

• Fatty dishes. Foods that contain a lot of butter or vegetable oil increase the risk of exacerbations of the cardiovascular system. Due to fatty foods, cholesterol is deposited in the blood vessels. Because of it, acute myocardial infarction can develop.
• Caffeine. This component is present in large quantities in coffee, tea and some other drinks. Because of caffeine, the mucous membrane of the stomach is irritated, the heart beats faster and the nervous system is overloaded. If you stop drinking cups of drinks with this substance, you will be able to avoid the occurrence of erosions in the duodenum.
• Salt. The food should be limited as it overloads the kidneys and increases blood pressure.

People suffering from lupus erythematosus should give up alcoholic beverages and cigarettes. They are already harmful in themselves, but in combination with medications they can lead to disastrous consequences.

Prognosis for patients

The prognosis will be favorable if the disease is detected early in its development. At the very beginning of lupus, tissues and organs are not subject to severe deformation. Mild rashes or arthritis are easily controlled by specialists.

Advanced forms of SLE will require aggressive treatment with large doses of various medications. In this case, it is not always possible to determine what causes more harm to the body: large dosages of drugs or the pathological process itself.

Lupus erythematosus cannot be completely cured, but this does not mean that you cannot live happily with it. If you seek medical help in time, you can avoid serious problems. If you follow medical recommendations and lead a correct lifestyle, the patient will not have to limit himself in many ways.

Complications and progression of the disease are possible if a person has chronic infectious diseases. Frequent vaccinations and colds also have an impact. Therefore, such a patient needs to take care of his health and avoid factors that negatively affect his body.

Preventive actions

Prevention of SLE will help prevent relapses of the disease and stop further progression of pathological processes. Secondary measures promote timely and adequate treatment of lupus.

Patients should undergo regular medical examinations and consult with a rheumatologist. The drugs must be taken in the prescribed dosage for a certain period of time.

A state of stable remission can be maintained with hardening, therapeutic exercises and regular walks in the fresh air. The patient must follow a work-rest regime, avoiding unnecessary psychological and physical stress. Adequate sleep and proper nutrition are important not only for improving the condition of the disease, but also for the normal functioning of the entire body.

If isolated areas of affected skin have been identified in a person, it is necessary to find out whether any of his relatives have been diagnosed with the disease. A person with lupus should avoid ultraviolet radiation and stay away from direct sunlight. In the warm season, you need to use special ointments that can protect your skin from the negative effects of the sun. A person suffering from SLE needs to give up bad habits that only aggravate his condition.

Skin diseases can occur quite often in people and manifest themselves in the form of extensive symptoms. The nature and causal factors that give rise to these phenomena often remain objects of debate among scientists for many years. One of the diseases that has an interesting origin is lupus. Disease has many characteristic features and several basic causes, which will be discussed in the material.

Systemic lupus erythematosus, what kind of disease is it? photo

Lupus is also called SLE - systemic lupus erythematosus. What is lupus is a serious diffuse disease associated with the functioning of connective tissue, manifested by systemic lesions. The disease is autoimmune in nature, during which healthy cellular elements are damaged by antibodies produced in the immune system, and this leads to the presence of a vascular component with damage to connective tissue.

The disease received its name because it is characterized by the formation of special symptoms, the most important of which is. It is localized in different places and is shaped like a butterfly.

According to data from the medieval era, the lesions resemble wolf bites. Lupus disease widespread, its essence comes down to the peculiarities of the body’s perception of its own cells, or rather, a change in this process, so damage to the entire organism occurs.

According to statistics, SLE affects 90% of female representatives; the first signs appear at a young age from 25 to 30 years.

Often the disease comes uninvited during pregnancy or after it, so there is an assumption that female hormones act as the dominant factors in its formation.

The disease has a familial nature, but cannot have a hereditary factor. Many sick people who have previously suffered from food or drug allergies are at risk of contracting the disease.

Lupus causes of the disease

Modern medical representatives have been conducting lengthy discussions regarding the nature of the origin of this disease. The most common belief is the extensive influence of family-hereditary factors, viruses and other elements. The immune system of persons susceptible to the disease is most sensitive to external influences. The disease, which occurs from drugs, is rare, therefore, after stopping taking the drugs, its effect ceases.

The causative factors that most often lead to the formation of the disease include:

1. Prolonged exposure to sunlight.
2. Chronic phenomena of a viral nature.
3. Stress and emotional overstrain.
4. Significant hypothermia of the body.

To reduce the risk factors for the development of the disease, it is recommended to prevent exposure to these factors and their harmful effects on the body.

Lupus erythematosus symptoms and signs

Sick individuals usually suffer from uncontrollable temperature changes in the body, headaches and weakness. Fatigue is often observed, and pain in the muscle area appears. These symptoms are ambiguous, but lead to an increased likelihood of the presence of SLE. The nature of the lesion is accompanied by several factors within which lupus disease manifests itself.

Dermatological manifestations

Skin formations occur in 65% of sick people, but only 50% have this characteristic “butterfly” on the cheeks. In some patients, the lesion manifests itself in the form of a symptom such as localized on the torso, limbs, vagina, mouth, nose.

Often the disease is characterized by the formation of trophic ulcers. Women experience hair loss and nails become very brittle.

Manifestations of orthopedic type

Many people suffering from the disease experience significant pain in their joints, and small parts of the hands and wrists are traditionally affected. Severe arthralgia occurs, but in SLE there is no destruction of bone tissue. Deformed joints are damaged, and this is irreversible in about 20% of patients.

Hematological signs of the disease

In men and representatives of the fair sex, as well as in children, the formation of an LE-cellular phenomenon occurs, accompanied by the formation of new cells. They contain the main fragments of the nuclei of other cellular elements. Half of the patients suffer from anemia, leukopenia, thrombocytopenia, which are a consequence of a systemic disease or a side effect of the therapy.

Manifestations of a cardiac nature

These symptoms may even occur in children. Patients may experience pericarditis, endocarditis, mitral valve damage, and atherosclerosis. These diseases do not always occur, but are at increased risk precisely in people who were diagnosed with SLE the day before.

Significant factors associated with kidneys

During the disease, lupus nephritis often manifests itself, which is accompanied by damage to the renal tissues, a noticeable thickening of the glomerular basement membranes occurs, and fibrin is deposited. The only symptom is often hematuria and proteinuria. Early diagnosis helps ensure that the incidence of acute kidney failure among all symptoms is no more than 5%. There may be abnormalities in work in the form of nephritis - this is one of the most serious damage to organs with the frequency of formation depending on the degree of disease activity.

Neurological manifestations

There are 19 syndromes that are characteristic of the disease in question. These are complex diseases in the form of psychoses, convulsive syndromes, and paresthesia. The diseases are accompanied by a particularly persistent course.

Factors for diagnosing the disease

• A rash in the cheekbones (“lupus butterfly”) and upper extremities appears extremely rarely (in 5% of cases); with facial lupus it is not localized there;
• Erythema and enanthema, characterized by ulcers in the mouth;
• Arthritis in peripheral joints;
• Pleurisy or pericarditis in acute manifestations;
• Damage phenomena with the kidneys;
• Difficulties in the functioning of the central nervous system, psychosis, convulsive state of particular frequency;
• Formation of significant hematological disorders.

The question also arises: lupus erythematosus - itches or not. In fact, the disease doesn't hurt or itch. If there are at least 3-4 criteria from the above list at any time from the beginning of the development of the picture, doctors make an appropriate diagnosis.

• Red décolleté area for the fair sex;

• rashes in the form of a ring on the body;

• inflammatory processes on the mucous membranes;

• damage to the heart and liver, as well as the brain;
• noticeable pain in the muscles;
• sensitivity of the limbs to temperature changes.

If treatment measures are not taken in a timely manner, the general functioning mechanism of the body will become disrupted, which will provoke many problems.

Is lupus a contagious disease or not?

Many people are interested in the question Is lupus contagious?? The answer is negative, since the formation of the disease occurs exclusively within the body and does not depend on whether the sick person has had contact with people infected with lupus or not.

What tests for lupus erythematosus should be taken?

Basic tests - ANA and complement, as well as a general analysis of blood fluid.

1. Donating blood will help determine the presence of a truss element, so it needs to be taken into account for initial and subsequent evaluation. In 10% of situations, anemia can be detected, indicating a chronic course of the process. The ESR indicator during illness has an increased value.
2. ANA and complement analysis will reveal serological parameters. Identification of ANA is a key point, since diagnosis is often differentiated from diseases of an autoimmune nature. In many laboratories, the content of C3 and C4 is determined, since these elements are stable and do not need to be processed.
3. Experimental tests are done so that special (specific) markers in the urine are identified and formed so that it becomes possible to determine the disease. They are needed to form a picture of the disease and make treatment decisions.

You should ask your doctor about how to take this test. Traditionally, the process occurs as with other suspicions.

Lupus erythematosus treatment

Use of medications

The disease involves taking medications to increase immunity and generally improve the quality parameters of cells. A set of drugs or individual medications are prescribed to eliminate symptoms and treat the causes of the disease.

Treatment of systemic lupus carried out using the following methods.

• For minor manifestations of the disease and the need to eliminate symptoms, the specialist prescribes glucocorticosteroids. The most successfully used drug is prednisolone.
• Immunosuppressants of a cytostatic nature are relevant if the situation is aggravated by the presence of other symptomatic factors. The patient must drink azathioprine, cyclophosphamide.
• The most promising action, aimed at suppressing symptoms and consequences, has blockers, which include infliximab, etanercept, adalimumab.
• Extracorporeal detoxification agents have proven themselves widely and relevantly - hemosorption, plasmapheresis.

If the disease is characterized by a simple form in which a traditional skin lesion occurs (or), it is enough to use a simple set of drugs that help eliminate ultraviolet radiation. If cases are advanced, hormonal therapy and drugs to enhance immunity are taken. Due to the presence of acute contraindications and side effects, they are prescribed by a physician. If cases are particularly severe, therapy is prescribed through cortisone.

Therapy using folk remedies

Treatment with folk remedies also relevant for many sick people.

1. Decoctions of mistletoe from birch prepared by using washed and dried leaves collected in winter. The raw materials, having previously been reduced to a fine state, are poured into glass containers and stored in a dark place. In order for the decoction to be prepared efficiently, you need to add 2 tsp. collection and pour boiling water in the amount of 1 cup. Cooking will take 1 minute, infusion will take 30 minutes. Having expressed the finished composition, you need to divide it into 3 doses and drink it all in a day.
2. Willow root decoction Suitable for use by children and adults. The main criterion is the young age of the plant. The washed roots should be dried in the oven and chopped. You will need 1 tbsp of raw materials for cooking. l., amount of boiling water – glass. Steaming lasts for a minute, the infusion process lasts 8 hours. After expressing the composition, you need to take it in 2 spoons, the interval is equal to time intervals for 29 days.
3. Therapy tarragon ointment. For cooking you will need fresh fat, melted in a water bath, and tarragon is added to it. The components are mixed in a ratio of 5:1, respectively. All this needs to be kept in the oven for about 5-6 hours at low temperatures. After filtering and cooling, the mixture is sent to the refrigerator and can be used for 2-3 months to lubricate affected areas 2-3 times a day.

Using the product correctly, lupus disease can be eliminated in a short period of time.

Complications of the disease

The disease progresses differently in different individuals, and the complexity always depends on the severity and the organs affected by the disease. Most often, the legs, as well as rashes on the face, are not the only symptoms. Usually the disease localizes its damage in the kidney area, and sometimes it is necessary to take the patient for dialysis. Other common consequences include vascular and heart disease. which can be seen in the material, is not the only manifestation, since the disease has a deeper nature.

Forecast values

10 years after diagnosis, the survival rate is 80%, and after 20 years this figure drops to 60%. Common causes of death include factors such as lupus nephritis and infectious processes.

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