(This list is incomplete and should not be used for making a diagnosis. For a more complete set of diagnostic criteria see reference Aringer et al and Classification criteria for systemic lupus erythematosus)
– malar (over the cheeks of the face) “butterfly” rash,
– discoid skin rash (patchy redness with hyperpigmentation and hypopigmentation that can cause scarring),
– photosensitivity (skin rash in reaction to sunlight ultraviolet light exposure),
– aphthous ulcers (spontaneous ulcers of the lining of the mouth, nose, or throat),
– arthritis (two or more swollen, tender joints of the extremities),
– pleuritis or pericarditis (inflammation of the lining tissue around the heart or lungs, usually associated with chest pain upon breathing or changes of body position),
– kidney abnormalities (abnormal amounts of urine protein or clumps of cellular elements called casts detectable with a urinalysis),
– brain irritation (manifested by seizures convulsions and/or psychosis),
– blood-count abnormalities (low counts of white or red blood cells, or platelets, on routine blood testing),
– immunologic disorder (abnormal immune tests include anti-DNA or anti-Sm (Smith) antibodies, falsely positive blood test for syphilis, anticardiolipin antibodies, lupus anticoagulant, or positive LE prep test), and
– positive antinuclear antibody (ANA) tests. A positive ANA test may suggest the presence of an autoimmune disease, but it is non-specific. Also, one-third of individuals 65 years and older may have a positive ANA test without presence of any autoimmune disease.
The length of time since diagnosis may be suggestive of possible increased severity of associated disorders. Long-term therapy for SLE and accompanying conditions may also be associated with complications.
SLE is a multisystem progressive disease. SLE is associated with numerous debilitating systemic diseases and disorders (see below) with high morbidity and mortality, which need to be recognized and addressed.
- End-stage renal disease
- Oral mucous membrane lesions
- Cardiac valve pathosis
- Cutaneous lesions
- Cerebral vascular accidents
- Periodontal disease
- Temporomandibular joint disorder
- Cerebral dysfunction- psychosis
Flare-ups, or exacerbations, of a patient’s SLE may be caused by various triggers, including stress and oral infections.
Patients’ awareness of such events may identify, and prevent, flare-ups associated with dental care.
Treatment for SLE usually consists of immunosuppressive therapy. This type of therapy is associated with severe complications, such as adrenal suppression and susceptibility to opportunistic infections.
Apart from treatment to control the SLE, therapy for accompanying diseases and conditions are also instituted. This may include renal dialysis, neuropsychiatric therapy, and prevention and treatment of ischemic heart disease.
- Medical Disorders
- Oral Health Care Considerations