Sun sensitivity and lupus disease often go hand in hand. Sun sensitivity and UV light sensitivity (photosensitivity) is present in about 90 percent of patients with systemic lupus erythematosus (SLE), 40 to 60 percent of patients with discoid lupus, and about 70 percent of patients with subacute lupus erythematosus. Lupus sun sensitivity causes patients to be more likely to get sunburn after sun exposure and for the sunburn to last for a prolonged period of time.

In systemic lupus disease, sun exposure causes the classic lupus butterfly shaped rash that extends across the cheeks and bridge of the nose. In lupus discoid, sun exposure causes coin-shaped (discoid) lesions in exposed areas. In subacute lupus disease, sun exposure causes red, raised, circular lesions on the back, chest and arms, which can be confused with psoriasis. In addition, in lupus, sun exposure may cause other rashes, as well as joint pain and increased fatigue.

What is lupus disease? In patients with lupus disease, sun exposure, even for as little as 30 minutes, causes them develop a migraine headache, feel nausea or experience painful joints. In lupus, sun may cause an increase in the activity of the disease (flare). This may cause an acute attack of arthritis, pleurisy (chest pain when inhaling), fever, kidney disease, and epilepsy.

Scientists think that ultraviolet light (which is in sunlight, fluorescent lights, photocopiers, and VDUs) create antigens (protein molecules) on the skin surface which react with antibodies. The antibodies cause white blood cells to be drawn to the skin and attack it and a rash appears. The redness and inflammation may also be due to excessive nitric oxide present in the skin after lupus patients are exposed to sun. In lupus disease, sun is more likely to cause problems than artificial sources of light.

The UV rays in sunlight causes damage to the skin (keratinocytes), resulting in sunburn. In normal people, the sunburn goes away because the dead skin cells get cleared away quickly. In lupus disease, sun causes the damage to skin cells but the cells are not cleared away very well. The releases of the contents of the cells cause inflammation. In addition, the cell contents, which include Ro, are able to cause an immune response. The immune system responds to the cells by creating autoantibodies which attack the skin.

Prolonged sun exposure by those that work outdoors causes as three-fold increase in a Caucasian's chances of developing systemic lupus erythematosus, according to a study done by Patricia Fraser, M.D. published in February, 2003 issue of The Journal of Rheumatology. For people who already have lupus disease, the sun and UV light can cause or worsen rash lupus symptoms and systemic symptoms.

In patients with lupus disease, sun exposure causes them to have antibodies to Ro. In addition, other tissues in the body are affected because auto-antibodies travel to other tissues in the body, binding to target molecules and creating immune complexes. The immune complexes cause inflammation and the systemic symptoms of lupus. The reason why, in lupus, sun exposure only causes rashes on some parts of the body and not others is not known. It is also known why in lupus, sun exposure does not always cause sensitivity.

Sun exposure causes rashes in about 60 percent of those with lupus disease. Other problems are reported by about 10 to 20 percent of patients with lupus after sun exposure. However, the effects of sun exposure may not show up for a couple of weeks.

If you have lupus, sun exposure should be limited in order to prevent rashes and to prevent the disease from going into an active phase. You should stay out of the sun as much as possible, wear protective clothing and sunscreens (SPF 25 or greater), and stay out of the mountains and away from sunny countries, where UV exposure is at its greatest. It is also wise to be aware that reflected light from snow and water magnifies the exposure. In addition, if you have lupus, sun exposure can be reduced by putting UV film on windows.

 

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