Subject(s)
Lupus Erythematosus, Discoid/psychology , Quality of Life/psychology , Adult , Aged , Body Image/psychology , Cross-Sectional Studies , Emotions , Female , Humans , Income , Lupus Erythematosus, Discoid/epidemiology , Male , Middle Aged , Pilot Projects , Sex Distribution , Smoking/epidemiology , Smoking/psychology , Socioeconomic Factors , Texas/epidemiology , Young AdultSubject(s)
Lupus Erythematosus, Discoid/psychology , Quality of Life/psychology , Cross-Sectional Studies , Europe/ethnology , Female , Humans , Lupus Erythematosus, Discoid/ethnology , Male , Middle Aged , Native Hawaiian or Other Pacific Islander/ethnology , New Zealand/ethnology , Severity of Illness IndexABSTRACT
Once systemic disease is in remission, it is prudent to recognize the importance of alopecia in the patient's overall sense of well-being and quality-of-life clinical outcome. Scarring alopecia (scalp discoid lupus erythematosus) can be the presenting manifestation of lupus in more than half of affected individuals. Diffuse nonscarring alopecia in lupus is usually responsive to treatment of the systemic disease. Severe, often intractable burning pruritus of the scalp is a frequent complaint in dermatomyositis. Lichen planopilaris may mimic other autoimmune forms of scarring alopecia. Alopecia can also be caused by medications used to treat systemic autoimmune disease and fibromyalgia.
Subject(s)
Alopecia/etiology , Autoimmune Diseases/complications , Lichen Planus/complications , Lupus Erythematosus, Discoid/complications , Lupus Erythematosus, Systemic/complications , Alopecia/psychology , Autoimmune Diseases/psychology , Diagnosis, Differential , Humans , Lichen Planus/psychology , Lupus Erythematosus, Discoid/psychology , Lupus Erythematosus, Systemic/psychology , Quality of Life , Severity of Illness IndexABSTRACT
Lupus erythematosus is an autoimmune disease of unknown etiology with cutaneous and vascular lesions. Both discoid lupus erythematosus (DLE) and systemic lupus (SLE) affect the skin. Visible skin lesions in young women can cause loss of self esteem. In the present study we aimed to evaluate and compare the quality of life in SLE and LED through an observational study of 64 patients. These patients were divided into 2 groups: Group 1: SLE (n = 38); group 2: DLE (n = 26) and then completed the quality of life questionnaire - Dermatology Life Quality Index or DLQI. It was found that patients with DLE have a worse quality of life than patients with SLE. It is believed that this fact is generated by the difference in the spectrum of injuries.
Subject(s)
Lupus Erythematosus, Discoid/psychology , Lupus Erythematosus, Systemic/psychology , Quality of Life , Adult , Cross-Sectional Studies , Female , Humans , Male , Surveys and QuestionnairesABSTRACT
We present the case of a patient with cycloid paranoid psychosis, polycystic ovarian syndrome (PCOS) and lupus erythematosus discoides, whose peculiar course of illness illustrates the interdependence of endocrinological, immunological and psychosocial factors.
Subject(s)
Lupus Erythematosus, Discoid/diagnosis , Polycystic Ovary Syndrome/diagnosis , Schizophrenia, Paranoid/diagnosis , Adult , Antipsychotic Agents/therapeutic use , Behavior Therapy/methods , Borderline Personality Disorder/diagnosis , Borderline Personality Disorder/psychology , Borderline Personality Disorder/therapy , Combined Modality Therapy , Comorbidity , Drug Therapy, Combination , Female , Humans , Lupus Erythematosus, Discoid/psychology , Lupus Erythematosus, Discoid/therapy , Patient Admission , Polycystic Ovary Syndrome/psychology , Polycystic Ovary Syndrome/therapy , Schizophrenia, Paranoid/psychology , Schizophrenia, Paranoid/therapy , Stress Disorders, Post-Traumatic/diagnosis , Stress Disorders, Post-Traumatic/psychology , Stress Disorders, Post-Traumatic/therapyABSTRACT
BACKGROUND: In a recent open pilot trial, R-salbutamol sulphate, a well-known molecule with anti-inflammatory effects, was tested successfully on patients with therapy-resistant discoid lupus erythematosus (DLE). OBJECTIVES: To compare the efficacy and safety of R-salbutamol cream 0.5% vs. placebo on DLE lesions in a multicentre, double-blinded, randomized, placebo-controlled phase II trial. METHODS: Thirty-seven patients with at least one newly developed DLE lesion were randomized - 19 to the R-salbutamol cream 0.5% and 18 to placebo - and treated twice daily for 8 weeks. Efficacy was evaluated through scores of erythema, scaling/hypertrophy and induration as well as pain and itching; general improvement scored by the investigator and global improvement scored by patients' assessment were also evaluated. RESULTS: The mean area under the curve of improvement for scaling/hypertrophy, pain, itching and global patient assessment was significantly better for the actively treated patients as compared with placebo (scaling/hypertrophy, P = 0.0262; pain, P = 0.0238; itching, P = 0.0135; global patient assessment, P = 0.045). Moreover, the percentage of patients without induration was significantly higher in the active group compared with the placebo group (P = 0.013), and a statistically significantly greater decrease in the size of the lesional area was also seen in the overall analysis of the R-salbutamol-treated patients (P = 0.0197). No serious adverse events were reported. CONCLUSIONS: Application of R-salbutamol cream 0.5% was safe and well tolerated. Statistically significant effects were seen on scaling/hypertrophy, induration, pain and itching as well as patient global assessment, suggesting that R-salbutamol could be a promising new topical therapy alternative for DLE.
Subject(s)
Albuterol/therapeutic use , Lupus Erythematosus, Discoid/drug therapy , Pruritus/drug therapy , Administration, Topical , Adult , Aged , Dose-Response Relationship, Drug , Double-Blind Method , Female , Humans , Lupus Erythematosus, Discoid/psychology , Male , Middle Aged , Patient Satisfaction , Pruritus/psychology , Skin Absorption , Stereoisomerism , Treatment OutcomeSubject(s)
Lupus Erythematosus, Cutaneous , Lupus Erythematosus, Discoid , Quality of Life , Skin/pathology , Humans , Lupus Erythematosus, Cutaneous/pathology , Lupus Erythematosus, Cutaneous/psychology , Lupus Erythematosus, Discoid/pathology , Lupus Erythematosus, Discoid/psychology , Pilot Projects , Prospective Studies , Severity of Illness Index , Statistics, NonparametricABSTRACT
OBJECTIVE: The purpose of this study was to verify whether stress worsens the clinical symptomatology perceived by patients with lupus erythematosus. Toward this end, we considered two types of stressors-daily stress and high-intensity stressful life events. METHODS: In 46 patients with systemic lupus erythematosus and 12 patients with chronic lupus discoid, we studied the stress they experienced daily for 6 months and their disease symptoms. During this period, we also analyzed the levels of C3 and C4 complements and anti-DNAn antibodies. The systemic lupus erythematosus activity (assessed by the Systemic Lupus Activity Measures) and cumulative organ damage (assessed by the Systemic Lupus International Collaborating Clinics/American College of Rheumatology Damage Index) were also analyzed. RESULTS: We did not find that high-intensity stressful life events produced a worsening of the symptomatology of the disease. However, using a time-series analysis (Box-Jenkins), we found that a high percentage of lupus patients (74.1%) perceived a worsening in their clinical symptomatology due to the effects of daily stress. Of this 74.1%, 53.4% worsened the same day they suffered the perceived daily stress, and the remaining 20.7% experienced an increase in symptoms both the same day and the following day. Subsequent Mann-Whitney analyses showed that the patients who worsened for 2 days because of the effects of stress had greater lupus activity, as evaluated by their levels of C3, C4, and anti-DNAn. CONCLUSION: Daily stress, and not stressful life events, worsened the clinical symptomatology perceived by lupus erythematosus patients. This increase extended at times to 2 days, and was associated with greater lupic activity.
