Outpatient management of systemic lupus erythematosus

Systemic lupus erythematosus (SLE) is often managed by primary care practitioners, who must coordinate the care with the support of subspecialists. The management of patients with such a serious and chronic disease can be both rewarding and challenging. This article reviews common problems and suggests management strategies.

Measurement of serum antinuclear antibodies can lead to an erroneous diagnosis if used as the sole basis for diagnosis. Infections are the leading cause of death in lupus patients, and immunizations and antibiotic prophylaxis need to be considered. Acute cutaneous SLE is exacerbated by exposure to ultraviolet light. Patients should avoid sun exposure. Specific treatment of cutaneous SLE includes topical corticosteroids and antimalarial agents. Some of the most perplexing problems seen in SLE relate to neuropsychiatric features. NSAIDs, corticosteroids, and antimalarials are the most commonly used medications for SLE.