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LOCATION
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PARKING
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MYTH OR FACT
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PATIENT PERSPECTIVE
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PATIENT TIPS
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Myth or Fact
I Can Have a Lupus Flare and Not Feel Sick.
Myth
Although many patients with lupus have obvious signs of disease activity, such as joint swelling or rash, there are other organs or systems that can be affected by lupus but not cause symptoms, at least initially. For example, problems with low blood counts or inflammation in the kidneys first may be detected in the blood or urine tests before any clinical symptoms are present. These lupus flares often can be serious and may cause permanent damage or other complications if not immediately treated. This is why it is necessary to continue taking your medications even when you feel well and to have regular examinations, blood tests, and urine tests to look for early signs of a lupus flare.
Kathy McKinnon, DO
I Am Not Photosensitive (sensitive to sunlight) Since I Have Never Developed a Rash from Sun Exposure.
Myth
Many lupus patients develop a rash after being exposed to sunlight or artificial ultraviolet (UV) light. But many patients do not realize that sunlight can cause symptoms other than a skin rash; it can also cause fatigue, joint pain, and problems with the kidneys, heart, or lungs. UV light from the sun can damage and kill skin cells. Patients with lupus may have problems processing and clearing these dead cells from the body. As a result, the body's immune system reacts to the contents released from these dead skin cells, contents not previously exposed to the immune system, and forms auto antibodies against these contents. In other words, the body's immune system turns against the body. Therefore, to avoid aggravating their condition, patients with lupus, regardless of their history of photosensitivity, should protect themselves from sunlight and avoid tanning devices.Sun-protection, including sun-protective clothing and sun block (SPF 30 or higher containing zinc or titanium) is an important basic therapy in managing lupus.
Amy Kao, MD, MPH
A "Butterfly" Rash Means I Have Lupus.
Myth
While it is true that the classic "butterfly" facial rash (named so for its distribution across the nose and cheeks) is one of the physical symptoms of lupus, not all facial rashes indicate lupus, and conversely some lupus patients never have a rash.
The typical facial rash of lupus, also called a malar rash (meaning over the cheeks), is red, may be flat or raised, and spreads over the cheeks and nose. It often starts or worsens after exposure to sunlight. Interestingly, it typically spares the nasolabial fold (the crease between the nose and the cheek). To make matters more confusing, there are several different kinds of rashes that can mimic the facial lupus rash. Rosacea, a common skin condition, may also appear in a butterfly pattern, but it usually covers the nasolabial folds and often has the appearance of small pimples. At times, these two rashes are difficult to distinguish, and referral to an experienced dermatologist and possible skin biopsy may be required. Other causes of facial redness that may be confused with a lupus rash include dermatitis, skin thinning from steroid use, and flushing. Contact dermatitis, atopic dermatitis, and actinic dermatitis may also be part of the differential diagnosis of a "butterfly" rash.
Betsy Kazienko, MD
If I Have Lupus, My Children Need to Be Tested for Lupus.
Myth
We believe that no single factor but rather a combination of several factors causes a person to develop lupus. There is overwhelming evidence that genetics plays a major role in whether a person will be susceptible to this disease. About 10% of lupus patients have a first degree relative (parent, sibling, child) with lupus. However, when lupus occurs in an identical twin, the other twin will develop lupus only about half of the time. This observation indicates that if you are born with "lupus genes" there are still non-inherited factors that seem to be required to develop the disease, similar to the flip of a coin. Since auto antibody tests (i.e. ANA test) are often positive in healthy relatives of patients with lupus who never develop an autoimmune disease, it is not useful to perform these tests on a person who feels well and does not have signs and symptoms of lupus. It is important, however, to be aware of the increased risk of autoimmune conditions in the families of patients with lupus. Seek medical evaluation promptly for any signs or symptoms that are not explained by other conditions or are suggestive of autoimmune disease.
Kathy McKinnon, DO
Since I Have a "Positive" ANA, I Must Have Lupus.
Myth
Antibodies are part of our immune system's defense against foreign substances. They attach to bacteria, viruses, or other foreign invaders, and play a key role in helping the white blood cells and other immune cells destroy and digest such invaders. ANA (antinuclear antibodies) are directed against proteins in the nucleus of cells that are not foreign, but part of self.
Millions of Americans have a positive ANA, but roughly less than 10% actually have lupus. Healthy people, especially those over age 60, as well as people with other types of autoimmune disorders, infections, and healthy relatives of SLE patients can have a positive ANA. There are certain medications that can cause a positive ANA, with or without lupus-like illness. For these reasons, additional criteria must be met before a definitive lupus diagnosis can be made.
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