Five Forms of Lupus

2 -  Discoid lupus usually affects only the skin causing chronic rashes and scalp patches to form, mostly on the face, neck or scalp. The rash may be more distinct on sun-exposed areas of the skin. In addition to sunlight, some patients are sensitive to many types of fluorescent light.

3 - Subacute cutaneous lupus erythematosus is distinguished by the character, appearance and duration of the skin lesions. The lesions typically are uniform in shape; the areas affected are generally sun exposed, and the lesions usually don’t result in scarring the skin.

4 - Drug-induced lupus. Some drugs can cause lupus-like symptoms to develop in some people, but when the offending drug is discontinued, the symptoms usually go away. Drug-induced lupus is seldom associated with kidney problems or nervous system complications.

5 - Neonatal lupus affects the fetus and newborn, who acquired some disease abnormality from the mother.

Complex hormones help explain why women are 85-95% of lupus cases, and why the disease can become more active during pregnancy and just after childbirth.  More men than women develop drug-induced lupus; one might conclude that the offending drugs are prescribed more frequently for men. The three most common drugs that cause lupus symptoms are procainamide, hydralazine and isoniazid.

There is no single test that can defend a lupus diagnosis. A patient’s reported history of symptoms, clinical observations and an ANA (antinuclear antibody) test, which is probably the best systemic lupus test available at this time. These combined disciplines help a physician arrive at a correct diagnosis. Sometimes, ruling out other illnesses may be a valuable adjunct in diagnosing lupus.

Most patients have a mild to moderate disease course with intermittent disease flares, which may require specific drugs to treat certain symptoms and an “equal dose” of supportive care. The value of a healthy support network is priceless and is prescribed as often as needed. For more severe lupus symptoms -- when the disease is very active, immunosuppressive drugs, i.e., prednisone, methylprednisolone, hydroxychloroquine and azathioprine, may be required.

As many as 16, 000 people develop the disease each year and there is an estimated 1.5 million cases of lupus in the U.S. The 5,000 who reportedly die with lupus in the United States yearly is under-reported, according to some sources. A lupus complication which resulted in a death is sometimes reported under some statistical category, other than lupus.

The outlook for those who suffer from lupus continues to improve. There is more general awareness about lupus and patients are more informed health consumers today than ever before. Health care providers now have a better understanding of the lupus-immunology, and it is my abiding hope that physicians today are less likely to discount the variety of symptoms that patients often report and are documented in their medical records.

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