Why lupus is so difficult to diagnose
Q: I have two friends who have lupus. One is having a lot of aches and pain, and the other seems to be tired all the time, confused, moody. Have they been diagnosed correctly? — Sonia J., Ocala, Florida
A: SLE (systemic lupus erythematosus) is the most common form of lupus, an autoimmune disease. SLE can present with a diverse array of symptoms; they can vary from mild to severe and can mimic other conditions.
For reliable diagnosis and treatment, it’s important to go to a rheumatologist who specializes in SLE. He or she uses blood tests that look for immunological involvement (certain antibodies) and the presence of clinical symptoms, such as fatigue, cognitive changes and psychological disruption, as well as skin eruptions and kidney, eye, muscle, joint, gastro, cardiac, endocrine or hematological problems.
After examination and diagnosis, it’s time to determine the best course of treatment.
Lifestyle choices can go a long way in helping reduce the impact of lupus on muscle, bones and organ systems. The first step is to maintain a healthy weight. Regular physical exercise, however possible, is essential.
Hydroxychloroquine, an anti-malarial drug, often is used initially to treat lupus-related mouth sores and skin lesions. When internal organs are affected, options include immunosuppressive drugs, steroids and the monoclonal antibody belimumab.
Q: I was in a car accident two years ago, and my collarbone was broken in two places. I ended up with a big, ugly scar. Is there any way to get rid of it? — Rachel Q., Los Angeles
A: Scars are a sign that the body was on the job, helping heal a wound. Depending on the type of trauma, there are ways to prevent or minimize scarring, or reduce it. It’s rare to be able to remove a scar completely.
Your first step is to find a plastic surgeon you can work with to explore your options.
For dark-colored scars, you can ask your doctor to recommend over-thecounter creams containing vitamin E, silicon, bleaching and brightening agents. To avoid discoloration, keep your scar out of the sun.
A steroid injection could make it softer and flatter. Dermabrasion also can smooth out a scar.
For raised scars, laser treatments that break down excess collagen are an option.
4. Scar revision is the surgical option. Any surgery can create new scar tissue, so discuss the benefits and risks.
Email questions for Mehmet Oz and Mike Roizen to youdocsdaily@sharecare. com.