Manifestations and treatment of patients with early lupus erythematosus

Obvious symptoms: facial erythema, ** will also appear erythema, there may also be fever, this disease should focus on the early stage**, after treatment, pay attention to prevention**.

1 Most patients with lupus erythematosus have arthralgia or arthritis in the absence of joint damage, and lupus erythematosus should be suspected if extra-articular symptoms such as fever, rash, leukopenia, etc. are present at the same time.

2. Some patients with lupus erythematosus in the early stage will have characteristic butterfly-shaped erythema on the face or 5mm-2cm erythema on the limbs, especially the fingers and palms, **, most of them tend to atrophy in winter, and the efficacy of topical steroid ointment is poor.

3 Raynaud's phenomenon is a group of syndromes in which the fingers and toes turn pale, purple and then flush due to cold or emotional agitation. In the early stage of lupus erythematosus, patients will have Raynaud's phenomenon in which the hands turn white and purple when exposed to cold.

4. Most patients with lupus erythematosus will have fever in the early stage, and the fever type is long-term low-grade fever (37-38), or intermittent low-grade fever; It may also be a flaccid high fever; There is also a lingering high fever, as high as 39 or more, which does not go away for several days.

Lupus erythematosus needs to be accepted as soon as possible**, otherwise the various complications are extremely serious, then you will know what are the symptoms of lupus erythematosus in the early stage.

Systemic lupus erythematosus is the most severe of the various types of lupus erythematosus. The vast majority of patients present with multisystemic damage, and a small number develop from other types of lupus erythematosus. Some patients are also accompanied by other connective tissue diseases, such as scleroderma, dermatomyositis, Sjögren's syndrome, etc., forming various overlapping syndromes.

The clinical manifestations of systemic lupus erythematosus are diverse, complex, and most of them are serious, which can endanger the lives of patients due to lupus nephritis, lupus encephalopathy and long-term use of large amounts of drugs.

Deep lupus erythematosus, also known as lupus panniculitis, is also an intermediate type of lupus erythematosus. **The lesion is a nodule or plaque, located in the deep dermis or subcutaneous adipose tissue, which varies in size and number, and has a normal or reddish surface with a firm texture and no mobility. Lesions can occur anywhere, most commonly in the cheeks, buttocks, arms, and to a lesser extent in the calves and chest.

After chronic, it can last for months to years, and then it remains atrophy and depression. Deep lupus erythematosus is unstable in nature and can exist alone and can later transform into discoid lupus erythematosus, systemic lupus erythematosus, or co-exist with them.

Neonatal lupus erythematosus, manifested as ** annular erythema and congenital heart block, is self-trapping, generally resolves spontaneously within 4 to 6 months after birth, and heart disease often persists.

Drug-induced lupus erythematosus is mainly manifested by fever, arthralgia, muscle pain, facial butterfly erythema, oral ulcers, and may have serositis. ANA, anti-histone antibodies, anti-SS-DNA antibodies, etc. may be positive. After stopping the drug, it gradually improves, and patients with more severe disease can be given an appropriate amount of glucocorticoids.

1. Symptoms such as muscle pain and mild muscle weakness can be congratulatory for the early symptoms of lupus erythematosus or occur during the course of the disease. Symmetrical polyarthroditis and pain mainly involving the fingers, hands, elbows, and knees, but there is no joint destruction on x-rays.

2 About 90% of patients with lupus erythematosus have irregular fever, mostly low-grade fever, accompanied by high fever when the disease worsens. Long-term low-grade fever is one of the early symptoms of lupus erythematosus.

3. In the early stage of lupus erythematosus, there will be butterfly erythema or discoid erythema, flat or higher than ** fixed erythema all over the neck, often not involving the nasolabial folds, discoid erythema, raised erythema covered with scales and hair follicle lesions.

4. Periungual erythema and distal arcuate plaque of the nail (toe) are characteristic in patients with early lupus erythematosus, which are the main symptoms in the early diagnosis of systemic lupus erythematosus.

1. The onset of the disease can be acute or slow, and most of the early manifestations are non-specific systemic symptoms, such as fever, especially low-grade fever, general malaise, fatigue, weight loss, etc. The disease usually alternates between mild and severe. Infection, sun exposure, medications, trauma, surgery, etc. can all induce or aggravate it.

2. The rash is common, and about 40% of patients with lupus erythematosus have a typical erythema on the face, called butterfly erythema. In the acute stage, there is edema, bright red color, slight telangiectasia and phosphorus flake desquamation, and in severe cases, blisters, ulcers, ** atrophy and pigmentation. The palm-sized thenar, finger and finger (toe) nails are annihilated with erythema around the body, and there are maculopapular rashes and purple spots on the exposed parts of the body.

The number of patients with various ** lesions accounts for about 80% of the total number of diseases, and the hair is easy to break, and there can be alopecia areata. 15-20% of patients with lupus erythematosus have Raynaud's phenomenon. Blisters and ulcers appear on the oral mucosa, accounting for about 12%.

A small number of patients with lupus erythematosus develop herpes zoster during the course of the disease.

3 About 90% of patients with lupus erythematosus have joint swelling and pain, and it is often the first symptom of the visit, and the most susceptible to involvement is the proximal interphalangeal joint of the hand, and the knee, foot, condyle, and wrist joints can be involved. Joint swelling and pain are mostly symmetrical. About half of patients with lupus erythematosus have morning stiffness.

X-rays are often unremarkable, and only a minority of patients with lupus erythematosus have joint deformities. Muscle aches and weakness are common symptoms.

4 About 50% of patients with lupus erythematosus have clinical manifestations of kidney disease, such as proteinuria, hematuria, casturine, leukocytouria, low specific gravity urine, edema, increased blood pressure, increased blood urea nitrogen and creatinine, etc., and almost 100% of electron microscopy and immunofluorescence examinations have renal pathological abnormalities, and nephritis is divided into focal proliferative type (mild) (FPLN), diffuse proliferative type (severe type) (DPLN), membranous type (MLN), mesangial type (minor variant) (MESLN) according to pathological characteristics. The clinical, transformational, exacerbation, remission, prognosis, and mortality vary by type.

9. Lung and pleural involvement accounts for about 50%, of which about 10% suffer from lupus pneumonia, pleurisy and pleural effusion are common, and most of the lung parenchymal damage is interstitial pneumonia and pulmonary interstitial fibrosis, causing atelectasis and pulmonary dysfunction. Lupus pneumonia is characterized by a patchy infiltrate in the lungs that can be transferred from one side to the other, and the hormone resolves**. In addition to lupus lung damage, bacterial infection is often secondary.

10. Almost all patients with lupus erythematosus have one or several hematologic abnormalities at a certain stage, including anemia, leukopenia, thrombocytopenia, and bleeding caused by anticoagulant substances in the blood.

11 Some patients with lupus erythematosus have swollen lymph nodes and parotid glands when the lesion is active. Ocular involvement, such as conjunctivitis and retinopathy, is more common, and to a lesser extent, visual impairment is common. Patients may have menstrual disorders and amenorrhea.

5 Some patients may present with gastrointestinal symptoms, such as upper gastrointestinal bleeding, blood in the stool, ascites, paralytic intestinal obstruction, etc., which are caused by vasculitis of the gastrointestinal tract, such as mesenteric vasculitis. The arteriovenous and venous accompaniment of mesenteric blood vessels innervates gastrointestinal nutrition and function, and if lesions occur, the innervated site produces corresponding symptoms, and in severe cases, it affects life. Mesenteric vasculitis can lead to gastrointestinal mucosal ulcers, edema of the small intestine and colon, obstruction, bleeding, ascites, etc., and clinical manifestations such as abdominal pain, abdominal distention, diarrhea, blood in the stool, black stool, and paralytic intestinal obstruction.

If not diagnosed in time, it can lead to intestinal necrosis and perforation, resulting in serious consequences.

6. Nervous system damage accounts for about 20%, once it appears, it mostly indicates that the condition is critical, and brain damage can cause mental disorders, such as excitement, abnormal behavior, depression, hallucinations, obsessive-compulsive thoughts, mental confusion and other epileptiform seizures.

7. The liver damage caused by systemic lupus erythematosus is mainly manifested as hepatomegaly, jaundice, abnormal liver function, and the presence of a variety of autoantibodies in the serum. Among them, hepatomegaly accounts for about 10%-32%, mostly 2-3cm below the cost, and a few can be significantly enlarged. There are many causes of jaundice caused by lupus erythematosus, mainly hemolytic anemia, viral hepatitis, biliary obstruction and acute pancreatitis.

8 About 10-50% of patients with lupus erythematosus develop cardiac lesions, either due to the disease itself or to long-term use of glucocorticoids**. Cardiac lesions include pericarditis, myocarditis, endocardial and valvular lesions, etc., which are manifested by chest tightness, chest pain, palpitations, heart enlargement, congestive heart failure, arrhythmia, heart murmur, etc., and a small number of patients with lupus erythematosus die of coronary artery infarction.