Lupus erythematosus

Lupus erythematosus: description

Lupus erythematosus (butterfly lichen) is an autoimmune disease. In this case, defense cells of the immune system (antibodies) attack the body’s own cell components and cause inflammatory changes. The exact causes of this dysregulation of the immune system are still unknown.

Lupus erythematosus is usually relapsing-type. The inflammatory changes primarily affect the skin. But there are also forms in which other organs are involved. On this basis, physicians distinguish essentially three major forms of the disease. In addition, there are some other, rarer forms of lupus, which are usually limited to the skin, for example, lupus erythematosus tumidus.

Chronic discoid lupus erythematosus (CDLE)

This form of lupus disease usually affects only the skin and is therefore sometimes called “skin lupus”. The relapses of the disease are accompanied by the formation of discoid, reddish-flaky skin lesions, which are particularly evident on sun-kissed body parts such as the face. Triggers of the relapses can be, for example, light, stress, minor injuries or infections. Chronic discoid lupus erythematosus usually develops between the 20th and 40th year of life.

Systemic lupus erythematosus (SLE)

This lupus variant also affects internal organs in addition to the skin. Read all about it in the article Systemic lupus erythematosus.

Subacute cutaneous lupus erythematosus (SCLE)

Subacute cutaneous lupus erythematosus occupies an intermediate position between the two types of disease mentioned above. In the affected patients, on the one hand, there are very extensive lesions on sunlit parts of the body and, on the other hand, disease-specific antibodies in the blood. The acute phase of the disease is often accompanied by muscle and joint pain. In rare cases, subacute cutaneous lupus erythematosus continues to develop into systemic lupus erythematosus.

Frequency of lupus erythematosus

Lupus erythematosus is common worldwide but a rare disease. In industrialized countries, about 12 to 50 out of every 100,000 people suffer from the autoimmune disease. It usually occurs between the ages of 15 and 25, with women being affected about ten times more frequently than men.

Lupus erythematosus: symptoms

What signs and symptoms can cause the autoimmune disease, read in the article lupus erythematosus – symptoms.

Lupus erythematosus: causes and risk factors

The exact causes of lupus erythematosus are not yet fully understood. According to experts, a genetic predisposition is the basis for the disturbance of the immune system on which the disease is based. In addition, other factors also seem to play a role. In addition to environmental factors such as UV light, these are primarily hormonal influences, as lupus erythematosus is much more common in women and girls than in men and boys (in female sex, the hormone balance is more variable than in the male).

drugs

Certain medications such as antihypertensive agents and epilepsy can cause a lupus-like syndrome, the so-called drug-induced lupus syndrome. After discontinuing the medication, the syndrome generally disappears.

Lupus erythematosus: examinations and diagnosis

At the beginning of the diagnosis of lupus erythematosus, the doctor will have a detailed discussion with the patient (in children with the parents) about the medical history (anamnesis). This is followed by a physical examination and further examinations.

skin examination

In the various forms of lupus typical skin lesions occur. Important for the diagnosis is therefore an examination with the dermatologist. He takes a tissue sample of the skin (skin biopsy) and examines it under the microscope.

Further investigations

Blood tests can also provide important evidence of autoimmune disease. For example, systemic lupus erythematosus and, in most cases, subacute chronic lupus erythematosus can detect specific antibodies in the blood.

In addition, any suspected lupus erythematosus must be clarified whether internal organs are affected by the disease. If so, this suggests a systemic lupus erythematosus. Read more about the extensive diagnostics of this form of lupus in the article Systemic lupus erythematosus.

Lupus erythematosus: treatment

The treatment of lupus erythematosus includes consistent sunscreen measures. Patients should avoid direct sunlight and use sunscreen with high protection against UV-A and UV-B radiation.

In addition, the inflammatory changes in the skin are treated specifically: Individual foci can be locally supplied with cortisone (as an ointment). In exceptional cases, a drug is administered, which not only has anti-inflammatory effects, but also affects the immune reactions (immunomodulatory drugs).

If these measures do not help or the lesions are very extensive, you may want to try the use of a drug that was originally developed for malaria. It is the antimalarial drug with chloroquine or hydroxychloroquine. Incidentally, pregnant and breastfeeding women do not take this remedy. This treatment with the antimalarial drug is successful in 75 percent of all cases. In general, the therapy is well tolerated. However, regular examinations of the ocular fundus are recommended because the therapy can rarely cause changes. The laboratory values ​​should also be regularly checked for patients with lupus erythematosus.

For highly inflammatory lesions, tablets or infusions of cortisone may also be helpful.

The treatment of systemic lupus erythematosus is more extensive, because in addition to the skin and internal organs are affected. Read more in the article “Systemic lupus erythematosus”.

Lupus erythematosus: Prevention

The chronic inflammatory autoimmune disease lupus erythematosus can not be prevented. However, one should avoid factors that can trigger the disease (with appropriate genetic predisposition) or disease relapses. In addition to factors such as stress and infections, this mainly includes intense sunshine. These should be avoided even with existing disease, because lupus erythematosus makes the skin more sensitive to sunlight.

Lupus erythematosus: disease course and prognosis

The prognosis for chronic diskoid lupus erythematosus is good because the condition is limited to the skin. Years or decades later, the disease can come to a standstill.

Subacute cutaneous lupus erythematosus also has a good prognosis. In less than five percent of patients, however, the disease continues to develop systemically Lupus erythematosus, In this form of lupus disease progression and prognosis depend on which organs are affected. If the kidneys, heart and lungs are involved, the disease often has a severe course and in some cases can even be fatal.