By: Richard Bleuze
Lupus is an autoimmune disease affecting one in every 185 Americans. There are four main types of lupus: systemic lupus erythematosus, discoid/cutaneous lupus, drug-induced lupus, and neonatal lupus.
Systemic Lupus Erythematosus
Systemic lupus erythematosus (SLE) is the most common form of lupus, and when the disease is referred to as simply “lupus,” this is usually the type meant. It is also the most severe form of the disease. This is because the effects of SLE are global, capable of affecting almost all the organs of the body. Most commonly, the skin, joints, kidneys, liver, and lungs are involved, although the heart and brain are also at risk. If untreated, this form of the disease can cause organ failure and, ultimately, death.
This form of lupus is best diagnosed using the antinuclear antibody test (ANA). This test is not always conclusive, however, and a rheumatologist should always be consulted.
Discoid/Cutaneous Lupus
Discoid lupus, unlike its systemic cousin, is limited to the skin. Usually, a red rash appears on the head, neck, or scalp following sun-exposure. The affected areas can become thick and scaly, and in some cases, they can cause scarring.
In about ten percent of cases, this form of lupus develops into the more serious systemic kind. Nothing can be done to prevent this transformation, and some medical scientists believe that these are not true cases of discoid lupus but rather the early manifestations of the systemic kind being misdiagnosed.
The best way to diagnose discoid lupus is through examining skin biopsies. In cases of discoid lupus, certain abnormalities can be found in the rash that are not found in the healthy skin around it.
Drug-Induced Lupus
Drug-induced lupus is, as the name implies, caused by certain drugs. Many different prescription medications, can have this effect, however, two drugs in particular have been implicated in a majority of cases. They are hydralazine, taken for hypertension, and procainamide, for arrythmia. The symptoms are similar to those of SLE but almost always fade away when use of the medication is discontinued.
Neonatal Lupus
Neonatal lupus can occur, although very rarely, when autoantibodies (antibodies targeted against the self) are passed from a pregnant mother with lupus to her developing fetus. These children often develop a rash within the first few weeks of life. The rash lasts until about six months of age. They have no further symptoms after that. In a very small percentage of cases, heart defects develop due to the lupus. This is irreversible, but usually quite treatable.
Prognosis
Lupus is chronic and incurable. The drug-induced and neonatal types usually clear up on their own, but the systemic and discoid do not, and continue to require lifelong treatment and medication.
