Musculoskeletal system systemic lupus erythematosus

Therapists also deal with the rehabilitation of musculoskeletal disorders that are caused by an autoimmune response. Many of these diseases attack connective tissues, and autoimmune diseases such as rheumatoid arthritis, dermatomyositis, and systemic lupus erythematosus are often the primary reason that patients undergo rehabilitation. Patients with a compromised immune system may develop musculoskeletal problems related to their immunodeficient state. Hence, immunomodulating drugs are frequently used in many patients receiving physical therapy and occupational therapy. 

Xenobiotic exposure can adversely affect bones, joints, connective tissue, and muscles. Rheumatoid arthritis, osteoporosis, osteomalacia, systemic sclerosis, scleroderma, systemic lupus erythematosus, and spina bifida are musculoskeletal diseases that have been associated with toxic chemical exposures. Most of these associations, however, have been made to single chemical exposures and not to mixtures. This chapter cites the evidence on which those associations are based and discusses the available examples of mixtures that have been implicated. 

Manifestations in the skin are nearly as common as those involving the musculoskeletal system. " The most well known of these is the butterfly rash, which occurs over the bridge of the nose and the malar eminences. The classic butterfly rash is seen in approximately one-half of patients and often is observed after sun exposure. In fact, photosensitivity is common to many SLE patients who present with cutaneous manifestations. Skin lesions characteristic of discoid lupus occur in 10% to 20% of patients with SLE and may occur without other clinical or serologic evidence of lupus. Some individuals are said to develop subacute cutaneous lupus erythematosus, the nature of whose lesions falls between discoid (one type of chronic... 

Wallace DJ. The musculoskeletal system. In Wallace DJ, Hahn BH, eds. Dubois Lupus Erythematosus, 6th ed. Philadelphia, Lippincott Wilhams Wilkins, 2002 629-644. 

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