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Treat to target in Lupus : a vague concept

As mentioned, the heterogeneity and the lack of measurable biomarkers has made treating to target almost impossible in lupus. Treating lupus is a mix of art, science and experience. Pre-empting a flare may be

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Treatment of skin conditions for rheumatologists
20

Treatment of skin conditions for rheumatologists

Pearls

1. Know the potency of your steroid creams.
2. Use steroids for shortest duration possible. Know the risks of topical steroids. Eg skin atrophy and redness and other systemic side effects
3. Give enough cream to the patients. This depends on the surface area, frequency and duration.
4. Do not hesitate to refer to a dermatologist. A time frame of 2 weeks was suggested if there is no improvement in the skin condition.

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19

PRES and SLE

A good article read on neuropsychiatric manifestations of autoimmune conditions. There are a lot of grey areas to Posterior Reversible Encephalopathic Syndrome (PRES). The causative pathobiologic mechanism is still pretty much unknown. It ranges from thrombosis, infections to vasculitis. In autoimmune conditions, particularly lupus, many patients would have a great deal of exposure to immunosuppressant therapy.

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2

Pyoderma Gangrenosum (PG)

This gentleman with a history of seropositive (RF and CCP Positive) rheumatoid arthritis presents with these skin lesion. He had deforming arthropathy of the small joints of his hands consistent with rheumatoid arthritis. Several large necrotic ulcerations were noted in the lower limbs. Vasculitic lesions were also noted.

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