מחכה לתשובה - לופוס

השאלה מעניינת ובמקום. חפשתי תשובה עבורך ואני מצרפת כאן (באנגלית):.
Is treatment with lasers, collagen, restalyne, Botox or Thermage okay for people with either cutaneous or systemic lupus? What about microdermabrasion chemical peels and sclerotherapy for spider veins?

A. With the recent attention on plastic surgery and other cosmetic procedures, more people -- including those with lupus -- are questioning the safety of various skin treatments. Some may be considering dermatologic interventions for disease-related reasons, including side effects from lupus treatment (such as stretch marks) or from lupus itself (such as scars from discoid lupus).

However, a distinction should be made between reconstructive or reparative treatments for damaged skin and purely cosmetic procedures. Lupus patients in remission who are left with permanent scarring may be treated the same way as a person who has been in a car accident or in a fire. Certainly we are cautious with these treatments because any technique that manipulates the skin could reactivate the lupus. There are a number of criteria we establish before considering a person with lupus for these types of skin treatments.

First, the person's lupus must be in full remission -- and his or her rheumatologist and dermatologist must agree with the planned treatment.

In the last three to four years, pulsed-dye and other laser treatments have been particularly helpful in reducing the blood vessels caused by the lupus malar, or "butterfly," rash. This is the same technology that has been used on children with port-wine birthmarks on the face.

CO2 laser resurfacing of scars has also shown promise in selected patients. Again, all patients considered for laser treatment are pre-screened as outlined above. We also make sure that any drugs they are taking will not significantly delay healing. Striae (stretch marks) are a very troublesome problem subsequent to steroid treatment. No one technology works as well as we would like.

Collagen has been used for years to fill in scars in the skin, often caused by acne or burns. The use of collagen in lupus -- or any autoimmune disease -- has been quite controversial for many years. Dermatologists who treat lupus patients with collagen have not seen an increase in significant or unusual reactions, but caution is advised. And, although we pre-test everyone for any allergic reaction, there also can be problems if a person is on high doses of immunosuppressives or cor