Systemic lupus erythematosus (SLE) is a multisystemic, autoimmune, rheumatic disease involving the joints and skin in up to 90% of affected individuals. SLE affects various organ systems simultaneously, and its course is typically recurrent, with periods of relative remission followed by relapses. Hand involvement is a common manifestation and can vary considerably from mild arthralgia to severely deformed hands. Treatment varies widely depending on the systemic involvement and disease severity, but conservative management generally focuses on a course of disease-modifying antirheumatic drugs (DMARDs) and other pharmacologic interventions, while surgical procedures like tendon rebalancing, arthrodesis and arthroplasty are typically reserved for patients with advanced deformity and severe functional impairments.1,2
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Reproduced from the International statistical classification of diseases and related health problems, 10th revision, Fifth edition, 2016. Geneva, World Health Organization, 2016 https://apps.who.int/iris/handle/10665/246208
The typical patient is a 42-year-old African-American woman who presents with a range of symptoms affecting several systems, including a malar rash, chest pain, shortness of breath, and fatigue, as well as arthralgia, stiffness, swelling, and loss of strength in her hands and wrists. The rheumatoid arthritis-like symptoms have advanced, which now interferes with her ability to perform many basic daily activities requiring the use of her hands.
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