Lupus, psoriatic arthritis, and scleroderma are several types of arthritis that make people more sensitive to sunlight – either because of arthritis itself or the medications they take to treat it. It is important for these people to include sun protection as part of their self-management plan.
The sun radiates two types of “invisible” ultraviolet light that are harmful if you are exposed to it for a long period of time – ultraviolet A (UVA) can age the skin and ultraviolet B (UVB) can burn the skin. Both UVA and UVB can alter the DNA of skin cells, increasing the risk of skin cancer. For people living with lupus, psoriatic arthritis or scleroderma, sun exposure can make symptoms worse or increase damage to skin cells.
Sun sensitivity is a hallmark of lupus. People with lupus experience one or many of these symptoms:
- “butterfly” rash over the bridge of the nose and the upper cheeks
- scaly, purplish lesions on the face and neck
- red, circular rashes on the chest, back and arms
Sun exposure can bring on these rashes or make existing rashes worse. Those with systemic lupus erythematosus find that exposure to the sun triggers a flare, including joint pain, fatigue, and fever.
Raynaud’s phenomenon is a condition in which there is an exaggerated blood vessel tightening in response to cold or emotional stress, restricting blood flow to certain areas of the body – most often the fingers, but sometimes the toes, ears, or the end of the nose.
The exaggerated vascular response (tightening) in Raynaud’s phenomenon is called vasospasm, which often occur in response to cold or emotional stress. With vasospasm, the fingers turn white and cold then blue with dilated veins followed by relaxation of the vessel and normal blood flow causing a red ‘flushing’
According to a recent article published in The New England Journal of Medicine, Raynaud’s affects approximately 3 to 5 percent of the population – women are more often affected than men. Raynaud’s phenomenon occurs in two forms – primary and secondary. Primary is the most common and has no underlying cause. Secondary is when Raynaud’s phenomenon occurs in combination with another autoimmune disease like scleroderma, rheumatoid arthritis, Sjogren’s syndrome or systemic lupus erythematous. The article also states that people who work with certain chemicals, like vinyl chloride, or vibrating tools like a jackhammer are also susceptible to secondary Raynaud’s. Continue reading
The 2013 Classification Criteria for Systemic Sclerosis helps patients identify and treat their systemic sclerosis (SSc) earlier. Systemic sclerosis is also known as scleroderma. This journal is developed by the American College of Rheumatology (ACR) and European League Against Rheumatism (EULAR) as an update to the 1980 version developed by the ACR.
In the new criteria, patients have systemic sclerosis if they have thickening of the fingers that extends from the proximal to the metacarpophalangeal joints. In addition or in lieu of, if a patient observes the following listed features, it may also indicate SSc.
- Skin thickening of the fingers
- Fingertip lesions
- Abnormal nail fold capillaries
- Interstitial lung disease and/or pulmonary arterial hypertension
- Raynaud’s phenomenon
- SSc-related autoantibodies
In an article in “Rheumatology update”, co-author of the 2013 journal Dr. Frank van den Hoogen from the Netherlands said: “The 1980 ACR criteria were not sensitive enough to identify patients with early disease or limited cutaneous system sclerosis.” Calcinosis, flexion contractures of the fingers, tendon or bursal friction rubs, oesophageal dilatation and dysphagia were not included in the criteria because of its lack in sensitivity and specificity. The new criteria have a sensitivity of 0.91 and specificity of 0.92. In comparison, the 1980 ACR criteria had a sensitivity of 0.75 and specificity of 0.72.
If you observe these features in someone you know, please share this article with them so they may obtain the proper treatment.