December 28, 2011 12:35 PM

Avoid ‘Sunburn’ If you have Lupus

By Zulkiple Ibrahim This is the second of two articles on Systemic Lupus Erythematosus (SLE), also known as lupus, while lupus is a widespread disease, awareness of it among Malaysians lags behind many other illnesses. According to medical authorities, if there were greater lupus awareness, lupus patients would not feel so isolated and would receive the support they deserve. KUALA LUMPUR, Dec 28 (Bernama) — Fans of Malay television drama will certainly recall a recent series named “Stanza Cinta,” in which a doctor told the lead character to avoid excessive sunlight. the lead character happened to be a patient diagnosed with Systemic Lupus Erythematosus (SLE), which is also known as “lupus’. According to medical experts, many people with lupus are sensitive to sunlight and ultraviolet radiation. Lupus patients should avoid being under the sun during the times when the sun is at its most intense, between lOam and 3pm. AUTOIMMUNE DISEASE Dr H. Tan, a medical specialist, said lupus is an autoimmune disease characterised by acute and chronic inflammation of various tissues of the body. he said autoimmune diseases are illnesses that occur when the body’s tissues are attacked by its own immune system. “People with lupus produce abnormal antibodies in their blood that target tissues within their own body, rather than foreign infectious agents. “As the antibodies and accompanying cells of inflammation can affect tissues anywhere in the body, lupus has the potential to affect a variety of areas,” he said, adding that lupus can cause diseases of the skin, heart, lungs, kidneys, joints, and nervous system. “A person cannot get lupus from another individual. it is not cancer and it is not related to AIDS,” he said. some scientists believe that the lupus can be precipitated or aggravated by only a brief period of sun exposure. he said the reason rashes develop is the ultraviolet (UV) waves in the sunlight. UV light damages cells in the skin (keratinocytes), causing them to die. In healthy people without lupus, these dead cells are cleared away quickly and any inflammation induced by the sun (sunburn) is short-lived. However, in lupus patients, skin cells may be more sensitive to sun-induced damage, and there is increasing evidence that the dying (apoptotic) cells are not cleared away efficiently. as a result, the contents of dying cells may be released and cause inflammation. also, cell contents such as genetic material and other molecules, which are never normally exposed to cells of the immune system, are available to generate an immune response. IMMUNE RESOPONSE Immune responses and inflammation are the normal reactions of the body to infection, but in lupus they are generated inappropriately by the dying cells, and the body mounts an immune response against its own cell constituents (autoimmunity). Dr Tan said the end result of this process in susceptible people with certain types of lupus is the development of characteristic photosensitive rashes. Antibodies are often found in people with these rashes, he said. “Why the rashes affect only some parts of the body at any one time and are not always sun-sensitive is still not understood,” he said. FLARE the rheumatologist said when symptoms of lupus appear, it is called a “flare.” “These signs may come and go. you may have swelling and rashes one week and no symptoms at all the next. you may find that your symptoms flare after you’ve been out in the sun or after a hard day at work,” said Dr Tan. even if a patient takes medicine for lupus, he or she may find there are times when symptoms become worse. Learning to recognise that a flare is coming can help the patient take steps to cope with it. Many people feel very tired or have pain, a rash, a fever, stomach discomfort, headache, or dizziness just before a flare. Steps to prevent flares, such as limiting the time a person spends in the sun and getting enough rest and quiet, can be helpful. ARE ALL LUPUS PATIENTS AFFECTED? Dr Tan said some 60 per cent of lupus patients get sun-induced rashes. “New immune responses can take over a week to develop, so the effects of sunlight will not necessarily be evident on the same day. “In general, all lupus patients are advised to avoid sun exposure, as it is one of the easiest ways of avoiding something that we know can make lupus worse in many sufferers,” he said. can photosensitive rashes and other sun-induced manifestations of lupus be prevented? to some extent photosensitive rashes and other sun-induced problems can be prevented by keeping sun exposure to a minimum and using sunblocks regularly, Dr H. Tan said. he advises against going out under the hot sun. “The sunblock lotion is effective against the UV light. “It is also advisable to wear long-sleeve shirts, long pants and a wide-brimmed hat when out in the sun. the use of UV film on windows may also be necessary for those who are particularly sun-sensitive,” he added. — BERNAMA

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