Lupus – (Systemic Lupus Erythematosus, SLE)

Serving Hamilton, Stoney Creek, Grimsby and surrounding areas

SLE – Malar Rash

Lupus – Butterfly Rash

Diagnosis:

  • Lupus is diagnosed based on several symptoms and signs being present in the same patient, which 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
  • If you are concerned that you may have lupus, please see your doctor

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 from tanning beds 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