The sun is blazing hot in midsummer, and some young ladies who love beauty grow red spots on exposed skin areas after sun exposure, some of which appear on the cheeks and are symmetrically distributed across the bridge of the nose, much like a purple-red butterfly on the face; in the freezing cold days of the winter months, even though people put on thick warm gloves, there are still individual young and beautiful girls who will also have “Some people know nothing about it, and some people are at a loss all day because of it. Here we will take you to know SLE correctly. Zhang Fengxiao, Department of Rheumatology and Immunology, Hebei Provincial People’s Hospital 1. What is SLE Systemic lupus erythematosus (SLE) is often referred to as “lupus erythematosus” or “lupus”, named after its facial erythema that resembles the bite of a wolf. It is a recurrent autoimmune disease with complicated clinical manifestations, varied and easily recurring, and can involve almost every system and organ in the body. If the disease is not diagnosed and treated in a timely manner, it can be life-threatening due to the involvement of important organs such as the heart, lungs and kidneys or secondary to serious infections. It is estimated that there are about 1 million SLE patients in China, and the incidence is increasing year by year. The onset of SLE is related to a variety of factors, among which genetic factors play an important role in the development of SLE. SLE has a family genetic predisposition, which means that members of SLE families have a greater tendency to develop the disease, but it is not a genetic disease, and the majority of children born to patients are normal and healthy. Although most patients have erythematous skin, and some of them are very dangerous, the disease is also called “lupus erythematosus”, but this disease does not develop due to close contact, so it is not an infectious disease. In the past, due to the lack of understanding of SLE, the short survival time and high mortality rate of patients, people were very afraid of this disease. In recent years, with the rapid development of rheumatology and immunology disciplines, the early diagnosis of SLE is no longer a problem, and new drugs and new therapies are constantly appearing, making a breakthrough in the treatment effect and prognosis of SLE, which is no longer an incurable disease. According to statistics, the current 10-year survival rate of SLE patients in China is more than 85%, which has reached the international advanced level. As long as the majority of patients can be diagnosed early, standardized treatment, the disease can be well controlled, and normal people like life and work, but also can have children. The etiology of SLE is not yet completely clear. It is generally believed that the development of SLE is the result of a combination of factors, including inheritance, sex hormones and other intrinsic factors, as well as environmental factors, infections, drugs and other extrinsic factors. The interaction of genetic factors, endocrine disorders, environmental factors and other factors leads to imbalance of the body’s immune system, producing a large number of autoantibodies, causing acute and chronic inflammation and necrosis of tissues, or cell destruction, resulting in damage to multiple systems of the body. SLE is a systemic disease that can affect all organs of the body, including the heart, lungs, liver, spleen, kidneys, brain and eyes, in addition to the skin, hair, bones and joints. Typical manifestations include butterfly-shaped erythema on the face with hair loss, mouth ulcers, sun allergy, joint pain, and white or purple hands and feet when exposed to cold. For unexplained fever, malaise, hair loss, general malaise, weight loss, facial erythema, erythema of the fingertips, recurrent oral ulcers, photosensitivity, and joint pain. Some also present only with hematuria, proteinuria, anemia, decreased white blood cell and platelet counts, which can easily be misdiagnosed as nephritis or blood disorders. Especially in young women of childbearing age, further immunological tests such as anti-nuclear antibodies, anti-double-stranded DNA antibodies, anti-Sm antibodies, and complement are required once certain symptoms or laboratory abnormalities mentioned above occur. Since SLE is a typical heterogeneous disease with various clinical manifestations and different manifestations at different stages of the disease, early diagnosis is more difficult, therefore, timely consultation with rheumatology and immunology specialists in regular hospitals should be made to avoid misdiagnosis and mistreatment. 2.How to treat SLE For the treatment of SLE with clear diagnosis, especially for moderate to severe SLE, hormone is the most effective drug, and there is no drug that can replace its role, and it is because of the use of hormone that many SLE patients have regained a healthy and happy life. Although hormones have many adverse effects, such as increased chances of infection, obesity, increased blood pressure, increased blood sugar, bleeding peptic ulcers, osteoporosis, and even femoral head necrosis, the benefits of these deficiencies far outweigh the disadvantages when compared to their therapeutic effects on SLE. Moreover, the use of hormones has a profound learning, the size of the dose, the speed of increase or decrease, must be based on the condition and vary from person to person. Patients must strictly follow the instructions of their rheumatologists and must not increase or decrease the dose or stop the medication without permission. Refusing to use or stopping hormones at will is not conducive to disease control and may even cause relapse or aggravation of the disease. Hormones are also often used in combination with immunosuppressive drugs, which not only help to accelerate the remission of the disease, but also help to reduce the dose of hormones and maintain the efficacy. These drugs include, for example, cyclophosphamide, morte-macrolimus, methotrexate, leflunomide, etc., all of which need to be applied under medical monitoring. In recent years, with the rapid development of science and technology, some new drugs and treatments have been introduced, such as plasma exchange and biological agents, which bring new hope for better treatment of SLE. Nevertheless, the status of hormone in SLE treatment is still unshakable, but due to the lack of understanding of the role and side effects of hormone treatment in SLE and the fear of some side effects caused by hormone, some people are resistant to the application of hormone and refuse to use it or use it irregularly, which delays the treatment and even loses the best time for SLE treatment. We once met a young female college student who was diagnosed with SLE in our hospital, and we formulated a comprehensive treatment plan for her, starting with the application of prednisone at 1 mg per kg of body weight per day, together with immunosuppressive drugs. Soon her daughter developed severe facial and limb edema, and when she came to us again, we could hardly recognize her face: the skin of her whole body was highly edematous, and when we pressed her finger gently, it was a pit. Some parts of her body kept oozing water along the sweat pores. Her eyes could not be opened, and the swollen bulbous conjunctiva was squeezed out from the slit of her eyelid, like a big drop of water hanging outside her eyes. The urinalysis showed a large amount of urine protein and the blood biochemistry showed severe hypoproteinemia. This is a typical case of unauthorized discontinuation of medication, resulting in exacerbation of the disease, making it more difficult for us to treat again, and the patient lost more health and money. Such examples are not uncommon and we are very saddened by them. Therefore, it is recommended that patients must know more about their disease and the basic knowledge of diagnosis and treatment, strictly follow the doctor’s instructions, use hormones reasonably and correctly, and never believe that there is any drug therapy that can replace or stop the use of hormones. To actively cooperate with the treatment, in order to have a better prognosis. 3. How to face SLE How should we cope with SLE when we have it? Patients often have two extreme attitudes, one is excessive fear, pessimism and despair; the other is not caring, self-indulgent and not cooperating with doctors, both extreme attitudes will lead to the adverse consequences of disease treatment failure, so it is very important to treat the disease correctly. The triggering and recurrence of the disease and mental factors also have a certain relationship, so patients themselves should pay attention to maintain a good emotional and mental state, strong and optimistic to face the disease, to avoid the impact of bad emotions. The question that most friends are most concerned about is “Can this disease be eradicated?” The cause of SLE is still unclear, so whether using Chinese medicine or Western medicine treatment is not possible to cure SLE, but there are enough drugs and means to make the disease in long-term remission, patients can live a normal life. Do not believe in the false advertisements under the banner of TCM, claiming to “eradicate” SLE with “ancestral secret recipes” and “pure Chinese medicine without hormones”, etc., so as not to be cheated and end up What you lose is not only money but also your health. On the issue of marriage and childbirth, SLE is not a contraindication to marriage and childbirth, but it must be maintained stable for at least half a year before you can consider having children. Many SLE patients not only have happy families, but also have cute and healthy babies. So, what should SLE patients pay attention to when they are pregnant? Because there is a correlation between SLE and sex hormones, some patients can induce SLE activity during pregnancy and several months after delivery. Therefore, patients should pay close attention to their body changes during pregnancy and perinatal period, such as blood pressure, breathing, foamy urine, rash, edema, etc. They should contact their specialist frequently, make detailed records, increase the frequency of follow-up visits so that the specialist can understand your condition and conduct regular prenatal checkups. Closely monitor the intrauterine development of the fetus and changes in the mother’s condition. In addition, about 40% of patients will develop sun allergy, the ultraviolet rays of the sun can cause skin damage, stimulate the body’s immune system response, thus triggering disease activity, so patients with light allergy, it is best to wear a hat or umbrella when going out, so as to avoid direct exposure to ultraviolet radiation and aggravate the disease. For ladies who love beauty, they are concerned about whether they can use cosmetics if they have SLE? In view of the fact that some cosmetics contain aromatic amine chemicals, which can induce lupus, and there are also examples of lupus occurring after hair dyeing or eyebrow tattooing, it is appropriate to use children’s creams with little irritation in order to avoid the stimulating effect of chemicals. There are generally no special contraindications regarding the diet of SLE patients, but some foods, such as celery, figs, mushrooms, smoked foods, alfalfa, bean pods, toon, parsley and other foods have induced photosensitivity or stimulated immune effects and should be avoided as much as possible. Avoid taking them. Finally, SLE patients should also do “five to five don’ts”: follow medical advice, take sufficient rest, have a good spirit, eat reasonably, and review regularly; don’t use drugs indiscriminately, don’t overexert yourself, don’t expose to the sun, don’t hear hearsay, and don’t stop drugs suddenly. SLE is not an incurable disease, and with early diagnosis and standardized treatment, you will regain a healthy and happy life.