Lupus and the Feet

Lupus is an autoimmune disease where the body’s immune system becomes over reactive and attacks normal, healthy tissue. This results in inflammation, swelling, and damage to joints, skin, kidneys, circulation, heart, and lungs.

Causes  of Lupus:

The exact cause is not known, but is believed to stem from both genetic and environmental factors (i.e. an inherited gene for lupus makes the disease more likely when the right environmental trigger is present).

Possible triggers include:

• Estrogen as symptoms tend to flare in women before menstrual periods and/or during pregnancy.
• Extreme stress.
• Exposure to ultraviolet light.
• Smoking.
• Some medications and antibiotics (i.e. sulfur and penicillin groups).
• Certain infections, such as cytomegalovirus (CMV), parvovirus, hepatitis C and the Epstein-Barr virus (in children).
• Chemical exposure to compounds found in well water and  dust.

How does Lupus Effect the Feet?

• Joint and muscle pains in the feet, even if there are no obvious signs of inflammation or swelling.
• Changes in walking patterns from stiff joints leading to further foot pathologies, such as bunions and hammertoes.
• Drugs used to treat the symptoms of Lupus can exacerbate hard skin formation. This combined with toe deformities may result in painful callouses and corns.
• Warts can appear due to the immunosuppressant medication.
• 25% of people with lupus have some sort of nail problem (i.e  slow growth, thin pitting nails that may become detached from the nail bed, thickened, darkened or ridged nails).
• Paronychia or inflammation around the nail cuticle.
• 20-30% develop Raynaud’s phenomenon which may cause chilblains.
• Serious foot problems are rare but any condition that reduces circulation to the toes can lead to tissue breakdown, ulceration and infection.
• Steroid medication can make the skin thinner and more prone to damage and infection.

Treatment for Lupus:

Although there is no cure for lupus, there are several measures that patients can take to manage with the disease.

• Use sunscreen to protect skin from both UVA and IVB rays.
• Nutritious and well-balanced diet with limited sugar and salt intake if on corticosteroids.
• Topical and systemic pain management for sore joints.
• Low-impact exercise such as walking, swimming, aerobics, and cycling to minimise muscle atrophy and lower the risk of osteoporosis.
• Professional support and rehabilitation to strengthen muscles, exercise, lower stress and recommend assistive devices.
• Don’t smoke, as this will increase circulation complications.
• Consider climate when choosing a place to live with minimal changes in climate and pressure.
• Control fatigue by remaining active and resting when required.
• Seek medical advice if considering pregnancy.

If you have lupus it is important to have your feet attended to by a podiatrist to keep the feet comfortable and minimise risk of pathology. At Proactive Podiatry we can attend to all your foot care needs.