Lupus patient education a priority

The management of systemic lupus erythematosus must go with patient education and if necessary the doctor, believe in Joint Bone Spine rheumatologists Lille.

"In order that the patient adheres completely to the treatment and the doctor-patient relationship is optimal, two key principles: the patient learn the signs of the disease so that it can identify and seek early, on the one hand, information on toxicity and the precautions prescribed medication, on the other hand, "they recommend in the preamble.

According to them, the power glucocorticoids requires specific dietary advice and an assessment of dietary habits. The low-salt diet, limited sugars, animal fat or cooked fat and rich in calcium, can not be explained in a few minutes and justifies a specialist consultation.

The other stages of patient education concerning photoprotection, the management of fatigue, exercise, smoking cessation and vaccinations.

1 / The photoprotection

The use of sunscreens Maximum blocking UVB and UVA is highly recommended. To be effective, these topics should be applied every two hours or every 3-4 hours for new forms long time and after swimming.

Must be avoided sunbathing, avoid places where the reverberation is as strong as the sea and the mountain, and the outputs when the UV radiation is maximum, be wary of certain protections as umbrella that blocks not all UV and does not prevent the reverberation or white T-shirts that provide only low photoprotection prefer tight clothing fabric like cotton or denim, protect the face by a wide-brimmed hat or a peaked cap and focus on long sleeves and pants.

The photosensitizing drugs should also be avoided: topical NSAIDs, some oral medications (some NSAIDs, tetracyclines, quinolones, phenothiazine ...). However, antimalarials are part of sunscreen treatment.

2 / Support fatigue and exercise

Fatigue reported in lupus is the result of muscle deconditioning, sometimes of depression, impaired quality of sleep or a symptom associated with the disease activity itself. It may also be the expression of a fibromyalgia syndrome.

Aerobic exercise gradually brings both physical and psychological benefits and should be encouraged.

3 / Smoking Cessation

A meta-analysis published confirms that smoking increased slightly but significantly the risk of developing lupus. "This is an incentive to encourage patients with lupus to stop all tobacco abuse, especially since that smoking can also reduce the effectiveness of skin antimalarials," warn the authors.

Smokers tend to be more active and more severe than non-smokers and former smokers disease. This finding supports the achievement of a comprehensive smoking cessation in SLE patients by providing the necessary assistance (psychological care, acupuncture ...), they say.

4 / Vaccinations

Infectious complications constitute the second cause of death in lupus patients, particular attention should be given to vaccination. It has been shown that pneumococcal vaccination and Haemophilus influenzae type B is possible, even under immunosuppressive.

It should nevertheless be vaccinated outside outbreaks of disease or concomitant infections. Required vaccines affect diphtheria, tetanus and polio recommended vaccines, pneumococcal, influenza by age and associated diseases. The vaccine against hepatitis B in patients at risk can be made without a history of disease flare associated with this vaccination.

Are cons-indicated in immunocompromised patients (in case of corticosteroid doses greater than 20 mg/24 hours and / or immunosuppressive therapy), live or attenuated vaccines: oral polio, rubella, measles, mumps, chicken pox, yellow fever and BCG.