SLE (Systemic Lupus Erythematosus) Symptoms, Pictures and Info
Systemic lupus erythematosus is a type of autoimmune disease that causes inflammation in various parts of the body. An autoimmune disease develops when the body's immune system, designed to fight off foreign invaders such as harmful bacteria, begins to attack a part of the body. The exact causes of systemic lupus erythematosus are largely unknown, although there appear to be both genetic and environmental factors involved. Symptoms vary widely from patient to patient, but may include muscle and joint pain, fatigue, or even organ damage or failure. There is no cure for systemic lupus erythematosus, so treatment options, such as the use of medications or lifestyle changes, are aimed at controlling specific symptoms.
In patients with systemic lupus erythematosus, the body has trouble deciphering the difference between helpful and harmful substances within the body. This confusion causes the body to attack itself in varying degrees. Some patients may experience mild symptoms that require little to no medical treatment. Others may develop severe complications from this disease, sometimes leading to death. There is no way to predict the course the disease will take in a particular person.
Some of the more common symptoms of systemic lupus erythematosus include muscle pain, joint pain and swelling, and varying degrees of fatigue. Swollen glands, fever, and nausea are also common. Some patients may experience a rash, known as a butterfly rash, across the bridge of the nose and extending across the face. Some patients with systemic lupus erythematosus may also develop a sensitivity to sunlight, seizures, or even psychosis.
Other potential symptoms of systemic lupus erythematosus may include frequent nosebleeds, blood in the urine, or the development of blood clots anywhere in the body. Abdominal pain, increased sensitivity to cold temperatures, or trouble swallowing have also been reported. Visual disturbances have been noticed in some patients with this form of lupus. Patients with the most severe forms of the disease may develop damage to the kidneys, heart, or lungs.
Treatment for the symptoms of systemic lupus erythematosus may include over-the-counter or prescription pain medications if muscle and joint pain are present. Steroid creams are available to treat the rashes that sometimes develop. If skin sensitivity is present, the patient should wear sunscreen and protective clothing, including sunglasses, when outside of the house. If organ damage is suspected, the patient will often be referred to an appropriate specialist in an effort to slow the progression of the disease as much as possible.
SLE symptoms may develop slowly over months or years, or they may appear suddenly. Symptoms tend to be worse during winter months, perhaps because prolonged exposure to sunlight in the summer causes a gradual build-up of factors that trigger symptoms months later.
People with SLE can develop different combinations of symptoms and organ involvement. Common complaints and symptoms include fatigue, low-grade fever, loss of appetite, muscle aches, arthritis, ulcers of the mouth and nose, facial rash ("butterfly rash"), unusual sensitivity to sunlight (photosensitivity), inflammation of the lining that surrounds the lungs (pleuritis) and the heart (pericarditis), and poor circulation to the fingers and toes with cold exposure (Raynaud's phenomenon). Complications of organ involvement can lead to further symptoms that depend on the organ affected and severity of the disease.
The most common symptom is joint pain, which occurs in about 90% of patients with SLE. Characteristics of this symptom vary widely:
It is often accompanied by swelling and redness.
It can last from hours to months.
It may be mild or severe.
It can occur in one joint, move from one to another, or flare erratically.
Pain often occurs in the morning and improves during the day, only to return later when the patient tires.
The joints most affected are fingers, wrists, elbows, knees, and ankles. (Joints in the spine and neck are not affected.)
Children may experience these symptoms as growing pains, and, in all patients, they may be the only symptoms for many years.
Fever occurs in 90% of patients with SLE and is usually caused by the inflammatory process of the disease, not by infection. It is low-grade except during an acute lupus crisis.
Three-quarters of patients with SLE have skin inflammation and skin lesions (ulcers, rashes, or other injured areas). About half of these lesions are photosensitive; that is, they are aggravated by ultraviolet (UV) radiation from sunlight, even from light coming through a window. (UV radiation may even trigger systemic flares in patients with SLE.)
A number of different skin conditions have been described in patients with SLE.
Discoid Lupus Erythematosus. About 20% of patients have discoid lesions. In such cases, the condition is often known as discoid lupus erythematosus (DLE). Patients with this condition may have the following skin abnormalities:
Discoid means coin-shaped, so these lesions are round and raised. They are also scaly. Untreated, the margins gradually extend outward as the center dries out and shrivels, causing severe scarring. If discoid lesions appear on the scalp, they can plug hair follicles and cause irreversible hair loss. Discoid lesions can also appear on the upper body.
A butterfly-shaped rash across the face may accompany this condition. This rash causes little scarring, although spidery, branching lines of swollen capillaries (the tiniest blood vessels) may appear. Most patients with this condition have only a limited skin disorder. In only about 10% of cases does discoid lupus develop into full-blown SLE.
Subacute Cutaneous Lupus Erythematosus. Subacute cutaneous lupus erythematosus (SCLE) can cause skin lesions on parts of the body that are exposed to sunlight. These lesions do not cause scarring.
Vasculitis. Patients with SLE sometimes develop inflammation in the blood vessels (vasculitis) that may have the following effects on the skin:
Red welts may form across large areas of the body.
Sometimes deep red bumps may appear, particularly on the leg, where they may ulcerate.
In some people, reddish-purple lesions appear on the pads of fingers and toes or near the nails of fingers and toes.
Lesions caused by vasculitis may ulcerate or blister if they erupt on mucous membranes in the mouth, nose, or vagina and can be painful if they occur on the throat.
Vasculitis can attack blood vessels in almost any other organ, including the brain, the heart, and the gastrointestinal tract.
Other SLE Symptoms
Other symptoms include:
Loss of appetite, nausea, and weight loss
Thought and concentration disturbances
Sleep disorders, such as restless legs syndrome and sleep apnea
Dryness of the eyes and mouth
Brittle hair or hair loss
Hair loss or breakage may also occur in about half of patients with SLE during severe flares or after pregnancy or severe illness. In such cases, hair grows back.
Raynaud's phenomenon is a condition in which cold or stress can cause spasms in impaired blood vessels, resulting in pain in fingers and toes. It occurs as part of the inflammatory response in blood vessels, which can narrow them and reduce circulation. In extreme cases, gangrene can result.
Conditions with Similar Symptoms
A number of conditions overlap with SLE:
Scleroderma: Hardening of the skin caused by overproduction of collagen
Rheumatoid arthritis: Inflammation of the lining of the joints
Sjögren syndrome: Characterized by dry eyes and dry mouth
Mixed connective tissue disorder: Similar to SLE, but milder
Myositis: Inflammation and degeneration of muscle tissues
Rosacea: Flushed face with pus-filled blisters
Seborrheic dermatitis: Sores on lips and nose
Lichen planus: Swollen rash that itches, typically on scalp, arms, legs, or in the mouth
Dermatomyositis: Bluish-red skin eruptions on face and upper body
Lyme disease: Bulls-eye rash, joint inflammation, and flu-like symptoms
More serious organ involvement with inflammation occurs in the brain, liver, and kidneys. White blood cells and blood-clotting factors also can be characteristically decreased in SLE, known as leukopenia (leucopenia) and thrombocytopenia, respectively. Leukopenia can increase the risk of infection, and thrombocytopenia can increase the risk of bleeding.
Inflammation of muscles (myositis) can cause muscle pain and weakness. This can lead to elevations of muscle enzyme levels in the blood.