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lupus rash

What Is Lupus?

Lupus is a lifelong disorder of the immune system. Immune cells attack the body’s own healthy tissues, leading to inflammation and tissue damage. Symptoms may be limited to the skin, but more often lupus also causes internal problems such as joint pain. In severe cases, it can damage the heart, kidneys, and other vital organs. Although there’s no cure, there are treatments that can minimize the damage.

Lupus Symptom: Joint Pain

2/25

Joint and muscle pain is often the first sign of lupus. This pain tends to occur on both sides of the body at the same time, particularly in the joints of the wrists, hands, fingers, and knees. The joints may look inflamed and feel warm to the touch. But unlike rheumatoid arthritis, lupus usually does not cause permanent joint damage.

Lupus Symptom: Butterfly Rash

3/25

A tell-tale sign of lupus is a butterfly-shaped rash across the cheeks and bridge of the nose. Other common skin problems include sensitivity to the sun with flaky, red spots or a scaly, purple rash on various parts of the body, including the face, neck, and arms. Some people also develop mouth sores.

Lupus Symptom: Nail Changes

Lupus can cause the nails to crack or fall off. They may be discolored with blue or reddish spots at the base. These spots are actually in the nail bed, the result of inflamed small blood vessels. Swelling may also make the skin around the base of the nail look red and puffy.

Lupus Symptoms: Fever and Fatigue

5/25

Most people with lupus experience some degree of fatigue. In many cases, it is severe enough to interfere with exercise and other daily activities. Most patients also run a low-grade fever from time to time. This unexplained fever may be the only warning sign in some people.

Lupus Symptom: Light Sensitivity

6/25

Many people with lupus are unusually sensitive to the sun and other forms of ultraviolet light. A day at the beach may trigger a skin rash in areas exposed to sunlight and may worsen other lupus symptoms. Certain medications can make people with lupus even more sensitive to UV light.

Lupus Symptom: Hair Loss

7/25

The symptoms of lupus tend to come and go, and this includes hair loss. Patients may go through periods where their hair falls out in patches or becomes thinner all across the scalp. Once the flare-up is over, new hair is likely to grow back.

Lupus Symptom: Raynaud’s

8/25

Some people with lupus develop a condition called Raynaud’s phenomenon. Their fingers and toes become painful, numb, and tingly in response to cold temperatures or emotional stress. This happens when small blood vessels spasm and restrict blood flow to the area. During an attack, the fingers and toes may turn white or blue. People can also have Raynaud’s without having lupus or any serious health complications.

Lupus or Something Else?

9/25

When lupus begins, it can look a lot like rheumatoid arthritis, which causes joint pain and swelling, or fibromyalgia, which causes fatigue and pain. One aspect that sets lupus apart is the combination of skin rashes with joint pain and fatigue. There are also lab tests that can help distinguish lupus from other diseases.

Diagnosing Lupus

10/25

Diagnosing lupus can be tricky. The disease can mimic other conditions, and it often takes a different course in different people. Many people have it for years before developing tell-tale symptoms. Although there is no one test for lupus, certain proteins usually show up in a patient’s blood. A blood test for antinuclear antibodies (ANAs) can provide a critical clue. Other lab tests may check cell counts, kidney function, and clotting time. A tissue biopsy of an involved organ such as the skin or kidneys sometimes helps with diagnosis.

Who Gets Lupus?

11/25

Anyone can get lupus. But it affects women 10 times more often than men. Aside from being female, your odds of getting the disease are higher if you are:

  • African-American, Latino, or Asian
  • Between the ages of 20 and 40
  • Related to someone with lupus

Types of Lupus

12/25

When people say “lupus,” they usually mean systemic lupus erythematosus (SLE), the most common and serious type. But there are other types. Cutaneous lupus erythematosus — also called discoid lupus — is limited to the skin and doesn’t cause the organ damage that sometimes occurs with SLE. The most common symptom is a circular rash. Drug-induced systemic lupus causes temporary lupus symptoms in people who take certain medications.

Medical Treatments for Lupus

13/25

There are ways to control the symptoms of lupus. These include corticosteroid creams for rashes and nonsteroidal anti-inflammatory drugs (NSAIDs) for joint pain and fever. Antimalarial medications can help fight joint pain, ulcers, and rashes. Corticosteroids may also be given as pills. In severe cases, they can be given intravenously. People with severe lupus may benefit from drugs that suppress the immune system.

Self-Care for Lupus

14/25

Making some changes to your routine can also help reduce lupus flare-ups:

  • Cover up when you’re in the sun.
  • Don’t smoke.
  • Exercise regularly.
  • Improve your stress management skills.

Also be sure to get plenty of rest. Some people with lupus need up to 12 hours of sleep a night.

Lupus and Kidney Problems

15/25

As lupus progresses, it can interfere with the body’s organs. Up to three out of four people with lupus can develop kidney problems. These problems may not cause symptoms, though some people notice swelling in their legs or ankles. Most patients only learn about their kidney trouble when a urine test reveals blood or abnormal protein levels.

Lupus and Heart Problems

16/25

The most common heart problem linked to lupus is an inflammation of the sac around the heart. This may cause severe pain in the left side of the chest. People with lupus are also more likely to develop plaques that narrow or clog the arteries. This can lead to coronary artery disease. Other complications include heart valve disease and inflammation of the heart muscle. Call 911 immediately for chest pain, rather than trying figure out the cause yourself.

Lupus and Lung Problems

17/25

The tissue surrounding the lungs becomes inflamed in about a third of people with lupus. This may lead to painful breathing, or chest pain, or it may not cause any symptoms at all. Sometimes lupus causes chest pain that is not related to the lungs or the heart. Instead, the pain comes from an inflamed chest muscle or rib joint. Any chest pain should be promptly evaluated by a doctor.

Lupus and Digestive Problems

18/25

Digestive problems are not common with lupus, but some people may experience belly pain, nausea, vomiting, difficulty swallowing, or inflammation of the liver or pancreas. This can be related to lupus itself or medications used to treat the disease. Some people tend to lose weight during lupus flare-ups.

Lupus and Anemia

19/25

Lupus and the medications used to treat it can contribute to anemia in some patients. This means the body has too few red blood cells, because it is not making enough, or red blood cells are being destroyed more quickly than they can be replaced. Symptoms include fatigue and shortness of breath.

Lupus and the Nervous System

20/25

Lupus can trigger a wide range of problems with the nervous system, most commonly headaches. Mild memory problems are a less common complaint that may come and go over time. Some people with lupus have a greater risk for a stroke, and in rare cases, the disease can lead to seizures.

Lupus and Mental Health

21/25

Depression and anxiety are a risk for people with lupus. This may be the result of the condition’s affect on the nervous system combined with the emotional strain of coping with a chronic illness. Be sure to discuss any concerns about your mood with your doctor or other health care provider. There are highly effective treatments for depression and anxiety.

Lupus and Pregnancy

22/25

Most women with lupus can get pregnant, though the condition increases the risk of complications during pregnancy. Because lupus symptoms come and go, the best time to get pregnant is when symptoms are at a minimum. Women who conceive when symptoms are in remission are less likely to have complications. Make sure your obstetrician knows you have lupus. Your medications may be modified and you may undergo extra monitoring to ensure a successful pregnancy.

Neonatal Lupus

23/25

Most babies born to women with lupus are entirely healthy. But in rare cases, the newborn of a mom with lupus may have neonatal lupus. This condition can cause a skin rash, anemia, or liver problems. The symptoms usually go away after a few months and don’t cause permanent damage. However, some babies with neonatal lupus can be born with a serious heart problem.

Living with Lupus

24/25

The fatigue and joint pain associated with lupus can make it more difficult to do your job or care for your children. You may have to cut back on activities or ask for help when symptoms flare up. But most people with lupus are able to continue with their usual activities.

Outlook for Lupus

25/25

Thanks to improvements in treatments for lupus, people with the condition are living significantly longer. The outlook for any given individual depends on how severe the disease is, and whether any vital organs are affected. But most people with lupus can expect to live a normal or nearly normal life span.

What is Shingles?

1/18

If you’ve ever had the chickenpox — and almost all adults have or have at least been exposed to it– there’s a good chance the virus is still at large in your body. The varicella zoster virus can lie dormant for decades without causing any symptoms. In some people, the virus wakes up and travels along nerve fibers to the skin. The result is a distinctive, painful rash called shingles.

What Does the Shingles Rash Look Like?

2/18

The shingles rash can be a distinctive cluster of fluid-filled blisters — often in a band around one side of the waist. This explains the term “shingles,” which comes from the Latin word for belt. The next most common location is on one side of the forehead or around one eye. But shingles blisters can occur anywhere on the body.

Shingles Symptoms: Before the Rash

3/18

The first symptoms of shingles appear one to five days before the rash. These early warning signs are usually felt in the location where the rash will develop:

  • Itching
  • Tingling
  • Burning
  • Pain

Other Symptoms of Shingles

4/18

While the localized pain and rash are the tell-tale signs of shingles, other symptoms may include:

  • Fever
  • Chills
  • Headache
  • Upset stomach

Shingles or Something Else?

5/18

Small blisters that appear only on the lips or around the mouth may be cold sores, sometimes called fever blisters. They’re not shingles, but are instead caused by the herpes simplex virus. Itchy blisters that appear after hiking, gardening, or spending time outdoors could be a reaction to poison ivy, oak, or sumac. If you aren’t sure what’s causing your rash, see your healthcare provider.

What Causes Shingles?

6/18

The varicella zoster virus is the culprit behind both chickenpox and shingles. The first time someone is exposed to the virus, it causes the widespread, itchy sores known as chickenpox. The virus never goes away. Instead, it settles in nerve cells and may reactivate years later, causing shingles. It’s also called herpes zoster, but it’s not related to the virus that causes genital herpes.

Diagnosing Shingles

7/18

A doctor can usually diagnose shingles just by looking at the rash. If you have shingles symptoms, see your healthcare provider even if you think you’ve never had chickenpox. Many childhood cases of chickenpox are mild enough to go unnoticed, but the virus can still linger and reactivate. To help prevent complications, it’s important to start treatment as soon as possible after the shingles rash appears.  

How Long Does Shingles Last?

8/18

Shingles blisters usually scab over in 7-10 days and disappear completely in two to four  weeks. In most healthy people, the blisters leave no scars, and the pain and itching go away after a few weeks or months. But people with weakened immune systems may develop shingles blisters that do not heal in a timely manner.

Who’s at Risk for Shingles?

9/18

Anyone who has ever had chickenpox can get shingles, but the risk increases with age. People older than age 60 are up to 10 times more likely to get shingles than younger people. Other factors that increase your risk include:

  • Some cancer medicines
  • Steroid medicines
  • Long-term stress or trauma
  • A weak immune system from illnesses such as cancer or HIV

A quarter of adults will develop shingles at some point, and most are otherwise healthy.

Is Shingles Contagious?

10/18

Yes, but not in the way you may think.  Your shingles rash will not trigger an outbreak of shingles in another person, but it can sometimes cause chickenpox in a child.  People who’ve never had chickenpox, or the vaccine to prevent it, can pick up the virus by direct contact with the open sores of shingles. So keep a shingles rash covered and avoid contact with infants, as well as pregnant women who have never had chickenpox or the varicella vaccine and people who may have weak immune systems such as chemotherapy patients.

Can Shingles Cause Chronic Pain?

11/18

In some people, the pain of shingles may linger for months or even years after the rash has healed. This pain, due to damaged nerves in and beneath the skin, is known as postherpetic neuralgia. Others feel a chronic itch in the area where the rash once was. In severe cases, the pain or itching may be bad enough to cause insomnia, weight loss, or depression.

Other Complications of Shingles

12/18

If the shingles rash appears around the eye or forehead, it can cause eye infections and temporary or permanent loss of vision. If the shingles virus attacks the ear, people may develop hearing or balance problems. In rare cases, the shingles virus may attack the brain or spinal cord. These complications can often be prevented by beginning treatment for shingles as soon as possible.

Treatment: Antiviral Medication

13/18

While there is no cure for shingles, antiviral medications can put the brakes on an attack. Prompt treatment can make a case of shingles shorter and milder.  Doctors recommend starting prescription antiviral drugs at the first sign of a shingles rash. Options include acyclovir (Zovirax), famciclovir (Famvir), or valacyclovir (Valtrex).

Treatment: Rash Relief

14/18

Over-the-counter pain relievers and anti-itch lotions, such as calamine, can help relieve the pain and itching of the shingles rash. If the pain is severe or the rash is concentrated near an eye or ear, consult your doctor right away. Additional medications, such as corticosteroids, may be prescribed to reduce inflammation.

Home Care for Shingles

15/18

Colloidal oatmeal baths are an old standby for relieving the itch of chickenpox and can help with shingles, as well. To speed up the drying out of the blisters, try placing a cool, damp washcloth on the rash (but not when wearing calamine lotion or other creams.) If your doctor gives you the green light, stay active while recovering from shingles. Gentle exercise or a favorite activity may help keep your mind off the discomfort.

Shingles Vaccine

16/18

The CDC recommends that healthy adults ages 50 and older get the shingles vaccine, Shingrix, which provides greater protection than Zostavax. The vaccine is given in two doses, 2 to 6 months apart. Zostavax is still in use for some people ages 60 and older.

Who Should Not Get the Vaccine?

17/18

Do not get the shingles vaccine if:

  • You have a severe allergic reaction, such as anaphylaxis, to any ingredient of a vaccine or to a previous dose of Shingrix
  • You have shingles now.
  • You are sick with an  illness and a fever of 101°F or higher.
  • You should also consider delaying the vaccine if you are pregnant or breastfeeding. Not enough is known about its safety for expectant and lactating women.
  • You have had a negative test for varicella; this would be uncommon for adults eligible for the vaccine, as most adults worldwide ages 50 and older have been exposed to the virus. You do not have to be tested before getting the vaccine.

Chickenpox Vaccine and Shingles

18/18

Since the late 1990s, most children in the U.S. have received the varicella vaccine to protect against chickenpox. This vaccine uses a weakened strain of the varicella zoster virus that is less likely to settle into the body for the long haul. 

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