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All about autoimmune diseases

It is estimated that more than 20 million Americans are currently living with an autoimmune disease. Because many autoimmune diseases impact the body in different ways, doctors use many factors, such as patient familial history and blood test results to successfully diagnose an autoimmune disease. Baylor experts in the fields of rheumatology and dermatology give insight into some of the most common autoimmune diseases people face.

Rheumatology

A view from a low angle showing a doctor writing notes on a clipboard while talking to a seated patient.Rheumatoid arthritis is one of the most common autoimmune diseases, affecting 1% of the general population. Symptoms include painful, stiff, swollen joints, usually in the hands, wrists and feet. Breakthroughs in medicine allow doctors to help patients diagnosed with rheumatoid arthritis go about their daily lives.

“There are so many new medications that have been discovered in recent years,” said Dr. Grace Hsiao-Wei Lo, assistant professor of medicine, “In rheumatoid arthritis, the biologic agents such as etanercept and adalimumab have revolutionized our ability to control the inflammation that causes symptoms in rheumatoid arthritis.”

Other autoimmune diseases that rheumatologists study and treat include systemic lupus erythematosus, systemic sclerosis and vasculitis. Dr. Lo recommends patients diagnosed with an autoimmune disease work with a good rheumatologist who communicates well to help navigate diagnosing and their disease.

Dermatology

Vitiligo and alopecia areata are two common autoimmune diseases specific to dermatology.

Vitiligo affects up to 2 percent of the population and it is thought that genetics and environmental triggers lead to the destruction of melanocytes, which normally function to confer skin pigment. As a result, patients experience white patches surrounded by normal skin that are usually asymptomatic.

Alopecia areata affects up to 2 percent of the population and as with vitiligo, the exact ways alopecia areata forms has not been fully found. Genetic susceptibility to T-cell driven autoimmunity against hair follicles is thought to play a key role in the cause of this disease. Common symptoms include symptomatic well-demarcated patches of non-scarring hair loss, with some patients experiencing total hair loss. Nail changes, such as grid-like pitting, may be seen as well.

“One thing to note is, although vitiligo and alopecia areata are not ‘dangerous’ conditions, they are often visible conditions that consequently lead to emotional distress and social withdrawal,” said Dr. Vicky Zhen Ren, assistant professor of dermatology. “Online support groups and organizations, such as the National Alopecia Areata Foundation, may offer psychosocial support and educational resources for patients and family members.”

Though there is no “cure” for either condition, Ren said dermatologists can provide therapies that may lead to improvement. Recent developments in medications such as janus kinase (JAK) inhibitors appear promising in treating vitiligo, based on early clinical trials. A JAK inhibitor also has recently become the first FDA-approved systemic therapy for severe alopecia areata.

Call the Baylor Medicine Infusion Center at 713-798-4414 for physician order infusion treatments for Rheumatoid Arthritis. 

-by Aaron Nieto

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