• Systemic lupus erythematosus is an autoimmune
disease of the body's connective tissues.
• Autoimmune means that the immune system attacks
the tissues of the body. Attacks parts of the cell
• Between the ages of 15 and 40, although it can show
up at any age.
A healthy immune system produces proteins
called antibodies and specific cells called
That help fight and destroy viruses, bacteria, and
other foreign substances that invade the body.
In lupus, the immune system produces antibodies
against the body's healthy cells and tissues.
• These antibodies, contribute to the inflammation of
various parts of the body and can cause damage to
organs and tissues.
• Lupus can affect :-
-joints, skin, kidneys, heart, lungs, blood vessels, and
Types Of Lupus Erythematosus
1. Discoid lupus erythematosus :-
is a chronic skin disorder, red, raised rash appears on
the face, scalp, or elsewhere. The rash may last for
days or years .
2. Sub acute cutaneous lupus erythematosus:-
refers to skin lesions that appear on parts of the body
exposed to sun. The lesions do not cause scarring.
3. Drug-induced lupus :-
is a form of lupus caused by medications. Many
different drugs can cause drug induced lupus.
4. Neonatal lupus :-
is a rare disease that can occur in newborn babies of
women with SLE .
5. Sjögren's syndrome is an autoimmune disorder in
which immune cells attack and destroy the exocrine
glands that produce tears and saliva.
Secondary sjogren’s syndrome
1. Dry eyes
2. Dry mouth
• The symptoms of SLE come on in waves, called flares
• general discomfort, extreme fatigue, fever, and
weight loss at some point.
Common Symptoms of Lupus
1. Painful or swollen joints and muscle pain
2. Unexplained fever
3. Red rashes, most commonly on the face
4. Chest pain upon deep breathing
5. Unusual loss of hair
6. Pale or purple fingers or toes from cold or stress .
1. A conservative regimen of physical and emotional
rest is required.
2. protection from direct sunlight.
3. A healthful diet.
4. prompt treatment of infections.
5. Pregnancy must be planned for times when the
disease is under control, and the patient is on
Non steroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen
(Plaque nil) It may be used alone or in combination with other drug.
hydroxychloroquine, quinacrine (available compounded), chloroquine
Used in lupus over 50 years
Very safe, risk of retinal toxicity low
Eye exam once year
4- Immunosuppressive : -
For some patients whose kidneys or central nervous
system are affected by lupus, such as
Restrain the overactive immune system by blocking
the production of immune cells.
1. Minimize appearance of lesions.
2. Alleviate discomfort
3. Minimize fatigue.
4. Maintain weight at optimal range
5. Teach the patient to recognize fever and signs and
symptoms of infection.
6. Maintain joint function and increase muscle
7. Recognize anemia and develop a plan of care
8. Minimize episodes of bleeding.
9. Minimize incidence of infection.
10. Educate the patient about immunizations
11. Educate patient nutritional status.
1. Impaired skin integrity related to inflammation as
evidence by skin rash.
1. Wear protective eyewear.
2. Wear a wide-brimmed hat and carry an umbrella.3
3. Wear maximum protection sunscreen (SPF 15 or above)
in the sun. Sunbathing is contraindicated.
4. Avoid ultraviolet ray.
2. Acute pain related to inflammation as evidence by
Verbalized complaint of joint pain or stiffness.
Assess for the signs of joint inflammation (warmth,
redness, swelling) or decreased motion
Encourage the use of ambulation aids when pain is related
Encourage the use of nonpharmacological measures of
pain control such as relaxation, distraction, or guided
Consult an occupational therapist for the proper splinting
of affected joints.
3. Imbalance nutrition: less than body requirement
related to poor appetite.
Monitor calorie intake, weight.
Provide menu suggestion for high protein & calorie foods
Give high protein and calorie diet.
Provide liquid and frequent diet.
Plan periods of rest after food intake.
4. Deficient knowledge about self-management to be
performed at home.
Teach the patient about self-care.
Give strong message to stop smoking
Advise the patient to take regular treatment
Teach about exercise.