Lupus is a chronic inflammatory and autoimmune disease that, despite having no cure, can be controlled with the use of drugs that help reduce the action of the immune system, such as steroids and immunosuppressants, in addition to care such as the application of sunscreen diary, for example, according to the guidelines of the rheumatologist or dermatologist, which helps to control and prevent crises, according to the manifestations of the disease in each person.
All patients with lupus need medical follow-up, but the disease is not always active, and it is usually possible to maintain normal daily activities, such as working or performing leisure activities, for example.
The main symptoms that appear in this disease include red spots on the skin, especially in areas exposed to light such as the face, ears or arms, hair loss, low-grade fever, loss of appetite, joint pain and swelling, and kidney malfunction, for example. .
Although lupus has no cure, the disease can be controlled with follow-up with a rheumatologist, who will guide the use of drugs to reduce inflammation, which varies according to the type of disease, the organs affected and the severity of each case. Treatment options, which are also available through the SUS, are:
1. Sun protection
The use of sunscreen with an SPF of at least 15, but preferably above 30, is an important way to avoid the formation of skin lesions present in discoid or systemic-type lupus with cutaneous manifestations. The sunscreen or sun block should always be applied in the morning, and reapplied at least once more throughout the day, depending on local lighting and the possibility of exposure.
In addition, the use of clothing and hats are important to prevent the action of ultraviolet rays on the skin, when in sunny environments.
2. Analgesics and anti-inflammatory drugs
Medicines to relieve pain can be anti-inflammatory drugs, such as Diclofenac, or analgesics, such as Paracetamol, which are very useful for periods when there is a need for pain control, especially when the disease affects the joints.
Corticosteroids, or corticosteroids, are medications widely used to control inflammation. They can be used topically, in ointments used on skin lesions to help improve the skin and make it difficult to increase the size of wounds and blisters.
They are also used orally, in tablet form, made in cases of both mild and severe lupus or situations of exacerbation of the systemic disease, in which there may be damage to blood cells, kidney function, or impairment of organs such as the heart, lungs and nervous system, for example.
The dose and time of use depend on the severity of the situation, for each case. In addition, there is the option of injectable corticosteroids, more used in severe cases or in which there is difficulty in swallowing the tablet.
4. Other regulators of immunity
Some drugs that can be used together with steroids or used separately to control the disease are:
- Antimalarials, as Chloroquine, mainly in joint disease, being useful for both systemic and discoid lupus, even in the remission phase to keep the disease under control;
- Immunosuppressants, such as Cyclophosphamide, Azathioprine or Mycophenolate mofetil, for example, are used with or without steroids, to weaken and calm the immune system for a more effective control of inflammation;
- Immunoglobulin, is an injectable drug, made in severe cases in which there is no improvement in immunity with other drugs;
- Biological agents, such as Rituximab and Belimumab, are new genetically engineered drugs, also reserved for severe cases in which there is no improvement with other alternatives.
5. Natural Options
Some everyday attitudes, practiced at home, in conjunction with treatment, are also important to help keep the disease under control. Some options are:
- Do not smoke;
- Avoid alcoholic beverages;
- Practice physical activity 3 to 5 times a week, during periods of disease remission;
- Make a diet rich in omega-3, present in salmon and sardines, for example, 3 times a week;
- Consume foods that are anti-inflammatory and photoprotective, such as green tea, ginger and apple, for example, in addition to other types of fruits and vegetables.
In addition, it is essential to maintain a balanced diet, avoiding the consumption of foods rich in sugar and fat, as they contribute to the increase in triglycerides, cholesterol and sugar levels, which can lead to weight gain and diabetes, which can lead to uncontrolled disease.
Other precautions include avoiding live virus vaccines, except under medical advice, monitoring the levels of calcium and vitamin D in the blood, which can decrease with the use of corticoids, undergoing physical therapy to prevent and treat joint pain, in addition to avoiding the stress, which can influence disease outbreaks.
Lupus care in pregnancy
It is possible to get pregnant when you have lupus, however, it should preferably be a planned pregnancy, at a less severe time of the disease, and should be monitored throughout the period by the obstetrician and rheumatologist, due to the possibility of exacerbation of the disease.
In addition, medications are adjusted for pregnancy and during breastfeeding so that they are as less toxic as possible for the baby, usually with the use of low-dose steroids.