Environmental factors and staying too long under the sun are likely to trigger lupus, according to Professor Julian Thumboo from the Department of Rheumatology and Immunology at Singapore General Hospital.
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Lupus, or systemic lupus erythematosus (SLE) is an autoimmune diseases which is presented in a variety of ways with myriad symptoms, of which rash, joint pain and fever are the most common.
Diagnosing and treating lupus
A doctor will diagnose lupus after a blood test and a clinical examination. However, you should see a doctor only if your symptoms persist or are recurrent, advises Professor
Julian Thumboo, Head and Senior Consultant,
Department of Rheumatology and Immunology,
Singapore General Hospital, a member of the
SingHealth Group.
.A simple, shortlived rash or even a family history of lupus doesn’t justify testing.
"A blood test on its own is not conclusive, and I would not advise a blood test if there are no persistent or recurrent symptoms," he says. "Both the blood test and a clinical examination are necessary to determine if you have lupus."
Treatment involves controlling this chronic disease by suppressing the immune system with medicines. These include:
- Prednisolone and other types of steroids
- Non-steroidal anti-inflammatory drugs (NSAIDs), e.g. diclofenac
- Anti-malarial drugs, e.g. hydroxychloroquine
- Steroid-sparing medications, e.g. mycophenolate mofetil
Prolonged sun exposure can cause a flare-up
Exposure to direct sunlight can aggravate the symptoms of lupus, cautions Prof Thumboo.
"Ideally, a lupus patient should avoid direct sunlight as far as possible. If you have to go outdoors, even to cross the street in the daytime, protect yourself with an umbrella since sunblock alone is not fully effective," he says.
This means no swimming or exercising outdoors during the daytime for lupus patients. However, they can venture outdoors in the early morning or evening as long as they avoid direct sunlight.
Lupus patients who have "sticky blood", caused by the presence of antiphospholipid antibodies, need to take precautionary measures when taking long-distance flights since being immobilised for an extended period of time can trigger a blood clot in their legs or other parts of the body. The precautions they can take during the flight include walking around every couple of hours and wearing special stockings.
There is no reason why most if not all lupus patients can't lead a normal life and have children if they avoid the sun, make sure they take their medication as prescribed and see their doctor regularly, assures Prof Thumboo.
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