LUPUS
Serving Hamilton, Stoney Creek, Grimsby and surrounding areas.
Diagnosis:
Lupus is diagnosed based on several symptoms and signs being present in the same patient. These include.
- Facial rash (butterfly rash).
- Specific skin spots (discoid lesions).
- Skin biopsy.
- Blood tests. (e.g. ANA, Anti-DNA, ENA)
- Arthritis.
- Kidney problems.
- Blood problems. (e.g. low white count)
- Chronic sores in the mouth (canker sores).
- Sensitivity to the sun.
- The facial rash of lupus is NOT the same as rosacea. In rosacea patients often get pimples which are NOT associated with lupus.
- Just because a person has one of these signs does not mean that he or she has lupus. Several of these must be present to make a diagnosis.
Treatment:
Sun Protection:
- Sun exposure clearly causes lupus to flare or worsen.
- Wear a hat with a broad brim and protective clothing (e.g. long sleeves).
- Avoid the outdoors when the sun is strongest between the hours of 10 am to 3 pm.
- Wear a sunscreen which resists water and sweating and which protects against both UVA and UVB.
- Reapply sunscreen every hour if you are in water or sweating heavily.
- Wear sunscreen even if you are in the shade, it is still possible to burn.
- Avoid tanning beds. The ultraviolet light they produce causes skin cancer and may cause lupus to flare.
Topical Corticosteroids (Steroids, Cortisone):
- Cortisone creams (topical corticosteroids), lotions and gels are moderately effective.
- They are used twice daily on the affected areas until the spots disappear or turn brown. At that point the steroids should be stopped.
- Topical corticosteroids must be used for at least a month to see if they are going to be effective.
- The most common side effect would include, but not be limited to: thinning of the skin in the area to which they are being applied. This may appear as stretch marks, dimpling of the skin or bruising.
Intralesional Kenalog (Cortisone Injections):
- Cortisone injections work much better than the creams, gels and lotions.
- Injections are primarily use when people suffer from "discoid" lesions on the skin.
- The cortisone is injected directly into the affected areas.
- A lesion 5 cm (2 inches) in diameter would require about 8 injections.
- The injections are repeated at monthly intervals.
- The main side effect from the injections includes, but is not limited to: thinning of the skin. This may appear as stretch marks, dimpling of the skin or bruising.
- Skin thinning will usually resolve spontaneously once treatment is stopped.
Pills:
- A variety of pills are available.
- Please discuss your treatment options with your doctor.