Systemic Lupus Erythematosus (“SLE”)
When people use the term “lupus,” they usually refer to systemic lupus erythematosus, or “SLE.” Throughout this website, the term “lupus” is used to signal systemic lupus, since SLE constitutes the most common form of the disease. Systemic lupus is so-named because it affects many different organ systems in the body. It is marked by chronic inflammation, especially of the kidneys, joints, and skin. The cardiovascular and nervous systems can also be affected. Please explore the site for information on the manner in which SLE acts upon the various systems of the body.
Lupus Limited to the Skin
The term “chronic cutaneous lupus erythematosus” refers to a specific form of lupus that is limited to the skin. This form of lupus can exist in people who do not have systemic lupus. However, five percent or more of the people with this form of lupus may develop SLE later in life. Three types of skin lupus exist: chronic cutaneous lupus erythematosus (CCLE) (also known as Discoid Lupus Erythematosus [DLE]), subacute cutaneous lupus erythematosus (SCLE), and tumid lupus. A skin biopsy is usually obtained to diagnose skin lupus, and each form possesses its own characteristic lesions and pattern. For more information on the way that lupus affects the skin, please see the “Skin Lupus” article on this site.
Drug-Induced Lupus Erythematosus
Certain drugs can actually cause lupus-like symptoms in people who do not have SLE. However, this form of lupus is temporary and usually subsides within months of the time that the medication is stopped. In addition, many drugs that cause this form of lupus are actually losing favor among physicians. Medications known to induce lupus-like symptoms in some individuals include the blood pressure medications hydralazine and methyldopa, a heart medication called procainamide, and a drug called D-penicillamine, which is used in cases of metal poisoning. Other causes of drug-induced lupus include minocycline (used to treat acne) and anti-TNF (used to treat rheumatoid arthritis).
Neonatal Lupus Erythematosus
A certain form of lupus known as neonatal lupus may affect the babies of women with certain autoantibodies, namely anti-Ro, anti-La, and anti-RNP. About 1 in 1000 perfectly healthy women possesses either anti-Ro or anti-La, and a mother who gives birth to a child with neonatal lupus may not have lupus herself. In fact, only about 40% of women bearing children with neonatal lupus actually have lupus, but lupus or Sjogren’s (dry eye) syndrome may occur later in life. Usually neonatal lupus involves only the baby’s skin and subsides on its own, even without treatment. However, 1-2% of infants with neonatal lupus experience congenital heart block. This can be treated by the implantation of a pacemaker, and generally these children go on to lead healthy lives. Yet, rare deaths can occur from congenital heartblock, especially if major heart damage occurs in utero.
Childhood Lupus
The lupus that occurs in children affects the body in the same manner as adult lupus. However, boys are more likely to get childhood lupus than men are to get adult lupus, and usually childhood lupus affects certain organs, such as the kidneys, to a greater degree. The incidence of kidney disease in childhood lupus is about 2-times greater than that of adult lupus. Childhood lupus generally requires more aggressive therapy than adult lupus, yet physicians must keep in mind the risks of the long-term use of certain medications (e.g., prednisone).
Sources
- “Forms of Lupus.” Lupus Foundation of America. 1 July 2009.
- Wallace, Daniel J. The Lupus Book: A Guide for Patients and Their Families. 1st ed. New York: Oxford University Press, 1995. 47-51, 65-73. 159-63.
