SLE or lupus is a systemic autoimmune disease (or autoimmune connective tissue disease) that can affect any part of the body. The immune system attacks the body's cells and tissue, resulting in inflammation and tissue damage.SLE most often harms the heart, joints, skin, lungs, blood vessels, liver, kidneys, and nervous system. Characteristic facial rash of SLE is a butterfly rash which spread from one side of nose to other side. It is very important to diagnose this Rash and SLE in patients who attend a cosmetic Clinic in order to solve their facial disfiguration. SLE butterfly facial rash is resistant to treatment by variety of cosmetic procedures like ablative and non-ablative laser, IPL , chemical peel and PRP. The diagnosis of SLE and systemic treatment od this disease is paramount to cosmetic approach. Cosmetic practitioner should have a broad knowledge of dermatological disorder and relevant approach to them.

1. COMMON DERMATOLOGIC DISORDERS
SYSTEMIC LUPUS ERYTHEMATOSUS
Dr. Faramarz Didar
Cosmetic Facial UK Limited
www.cosmeticfacial.co.uk

2. autoimmune connective tissue disease) that can affect any
part of the body
2. the immune system attacks the body's cells and tissue,
resulting in inflammation and tissue damage
3. a Type III hypersensitivity reaction caused by antibody-
immune complex formation.
4. SLE most often harms the heart, joints, skin, lungs, blood
vessels, liver, kidneys, and nervous system.
5. The course of the disease is unpredictable, with periods of
illness (called flares) alternating with remissions.
6. Femal/male :9/1 age of child bearing(15-35)
7. SLE can be fatal, although with recent medical advances
8. Childhood systemic lupus erythematosus generally
presents with typical skin manifestations being butterfly
eruption on the face and photosensitivity
9. it often mimics or is mistaken for other illnesses.
10. SLE symptoms vary widely and come and go unpredictably
11. Common initial and chronic complaints include fever,
malaise, joint pains, myalgias, fatigue, and temporary loss
of cognitive abilities.
12. joint pain, with the small joints of the hand and wrist
13. the heart, such as pericarditis, myocarditis, and
endocarditis.

7. Treatment
Disease-modifying antirheumatic drugs(DMARDs)
are used preventively to reduce the incidence of flares, the
process of the disease, and lower the need for steroid use
 antimalarials such as plaquenil and immunosuppressants
(e.g. methotrexate and azathioprine
 Hydroxychloroquine is an FDA-approved antimalarial used
for constitutional, cutaneous, and articular manifestations
 Cyclophosphamide is used for severe glomerulonephritis or
other organ-damaging complications.
Immunosuppressive drugs:In more severe cases,
medications that modulate the immune system (primarily
corticosteroids and immunosuppressants) are used to control
the disease and prevent recurrence of symptoms
 Numerous new immunosuppressive drugs are being actively
tested for SLE
 Some of these drugs are already FDA-approved for
treatment of rheumatoid arthritis.Belimumab and Atacicept.
Analgesia:people with SLE suffer from varying amounts of
chronic pain, stronger prescription analgesics (pain killers)
may be used if over-the-counter drugs (mainly nonsteroidal
anti-inflammatory drugs) do not provide effective relief.
 Moderate pain (as dextropropoxyphene and co-codamol)
 Moderate to severe chronic pain (hydrocodone or longer-
acting continuous-release opioids, such as oxycodone, MS
Contin, or methadone.
Lifestyle changes, Renal transplantation, Intravenous
Immunoglobulins (IVIGs)