Lupus Erythematosus is an untreatable autoimmune condition that may be controlled through medication. The condition may be systemic or it may affect only the skin. Corticosteroids can be used as a topical or medication treatment to control the lupus flare-ups. However, when administered orally, the corticosteroids may have multiple side effects, so other types of treatment should be considered as well.
Topical corticosteroids are effective in controlling the cutaneous symptoms of lupus. The creams will be prescribed by the doctor and may have various concentrations of corticosteroids (typically up to five percent). The creams should reduce the appearance of the butterfly rashes on the cheeks that are specific for lupus patients. The creams should be applied even a few days after the rashes are completely gone. In some cases, the topical treatment must be accompanied by oral medication, as the rashes may be recurrent if the immune system is not suppressed. Corticosteroid injections may be recommended to reduce the appearance of subcutaneous lesions.
Oral corticosteroids are administered to patients that are affected by systemic lupus. Corticosteroids such as Prednisone, Methylprednisolone or Prednisolone will act as immune system inhibitors. The immune system in patients with lupus will produce a series of cells that will attack the body, and these have to be controlled.
The drugs are only available through prescription and should only be administered if the disease has serious symptoms such as joint swelling or inflammation of the padding of internal organs. The oral corticosteroids may also be prescribed when they are discovered to reduce the symptoms and keep the condition under control. The drugs may be used in conjunction with anti-malarial drugs and are typically not recommended in conjunction with non-steroidal anti-inflammatory drugs.
Side Effects of Corticosteroids
The main concern about the oral treatment with corticosteroids is the fact that there are side effects. The treatment is required for a long time, even for life in some cases. The most common side effects of these drugs include:
- Facial swelling
- Retention of water, especially if the patient continues eating sodium (present in salt)
- Increased appetite
- Irritability and mood swings
- Kidney damage
- Cushing's disease (adrenal insufficiency)
As the immune system is suppressed, the patient will be prone to other diseases and infections. The patient that is under corticosteroid treatment should get periodic blood tests that will make sure that there are no severe adverse reactions.
Administration and Dosage
The initial dosage of corticosteroids for lupus erythematosus treatment should be aggressive, so as to be able to suppress the immune system. The dosage will be established judging by the age and weight of the patient. As the treatment progresses, the dosage can be lowered and the drugs may even be administered once every two days. The treatment shouldn't be suddenly discontinued, even if there are severe side effects, as the abrupt discontinuation of the treatment may lead to adrenal insufficiency.