Disease of a thousand faces side effects. However, there are periods when the condition goes into remission, and for some people, the remissions are complete and long-lasting. Through it all, one of the main problems for those afflicted with lupus is the lack of public awareness of the disease and the effects it has on those who struggle with it. Ezyhealth & Beauty speaks with some sufferers for a better idea of living with lupus, as well as to a doctor for a better understanding of the disease.   A mother’s struggle (Felix: Pic of the twins and their mom if you want to use. See sharefolder for Msia lupus story. Can ask Jenny for picture.) May and Choy Wan, 24, model-celebrities No one is immune; the condition affects everyone including Ho Hoke Yin, mother to glamorous Malaysian celebrity twin models and show hosts May and Choy Wan. The 59-year-old was diagnosed with lupus at age 50, when the twins were 15.   “She had such bad joint pain that she could hardly move, which led to her being diagnosed with lupus. We were in high school then and didn’t realise how much pain she was going through. Later, we found out just how serious it was. My mother had a friend who was suffering from bone cancer. When they compared the dosages of their pain medication, my mother had the higher dosage,” said the Wan sisters. Their mother’s struggle with lupus has profoundly moved both sisters. “It has affected us in the sense that we have to be a lot more patient and understanding of our mother because she can’t do a lot of things that other With different symptoms, an uncertain cause and no cure, lupus is one of the most difficult diseases to deal with . Throughout the world, it is estimated that five million people suffer from SLE (Systematic Lupus Erythematosus) or lupus for short, and more than 100,000 new cases develop each year. However, the condition remains relatively obscure with little mainstream awareness.   What is it? Lupus is a chronic disease that strikes a person’s immune system. It causes large quantities of blood proteins called antibodies to be made and these antibodies react against the body’s own tissues – known as an “auto-immune” response. The damage is manifested in different ways, depending on where the antibodies are deposited. Due to its many symptoms, lupus is fairly difficult to diagnose and the initial few attacks are sometimes mistakenly diagnosed as other diseases.   The typical signs of lupus are as follows::      •   Reddish, butterfly-shaped rash across the nose and cheeks.:      •   Mouth ulcers.:      •   Hair loss.:      •   Inflammation of membranes around internal organs.:      •   Low platelet and white blood cell count.:      •   Swelling, redness and pain in joints.:      •   Nervous disturbances like fits, hallucinations, depression or severe migraine.   The cause of lupus is as yet unknown. There is also currently no cure for it and the drugs prescribed for treatment may have very harsh Knowing lupus Family wellness Speaking to Ezyhealth & Beauty, Dr Leong Keng Hong of Leong Keng Hong Arthritis & Medical Clinic at Gleneagles Medical Centre sheds light on some of the medical aspects of lupus. Dr Leong is the chairman of the Chapter of Rheumatologists, Chapter of Physicians in the Academy of Medicine in Singapore, as well as vice-president of the support group Lupus Association (Singapore).  Q What are the triggers or causes of lupus?  A This differs from person to person. For some, lupus flares up after infections like colds, and for others, exposure to the sun can trigger off a rash and other symptoms. These two are among the most common triggers. Some cases are mild enough for the patient to lead largely normal lives and others are very serious. The cases are extremely varied.   Q Can lupus be fatal?  A Yes, lupus can be fatal if it is not well-managed. A possibly fatal consequence is kidney failure or damage to the brain, but the truth is that lupus is much more manageable now than before. Survival rates have improved tremendously since the 1960s. Then, the five-year survival rate was 50%. Now, the 10-year survival rate is about 90%. Although all indications are that lupus is extremely unpredictable, it can be successfully controlled with an effective treatment programme. It is important that patients consult closely with their physicians.  Q Is there a likely profile for who could get lupus?  A Nine times more women than men get lupus, and the age of onset is usually during the childbearing years of between ages 20 and 50. This suggests hormones at work, although the hypothesis has not been proven. The youngest case I have ever seen was as young as six. Orientals or Asians, and Africans are more susceptible to lupus, and pregnancy tends to pose a higher risk of a flare-up due to hormonal upheaval. But with proper management, many patients can go on to have normal pregnancies.  Q What are the lupus statistics locally?  A We estimate that there are about 4,000 sufferers in Singapore, but there are no exact figures as this is not a registered disease. Some patients go undiagnosed as they may see a dermatologist for their rashes or an orthopaedician for joint swelling.   Q What treatment methods are there for lupus?  A Treatments are variable as the symptoms are so wide-ranging. Usually, as sun exposure and stress are the common triggers, avoidance of both and plenty of rest is advised. Medication is also an important treatment component. Common medications include corticosteroids that suppress inflammation; antimalarial drugs such as hydroxychloroquine that control skin problems and reduce inflammation; aspirin and non-steroidal anti-inflammatory drugs (NSAIDs) for pain and inflammation relief; and immunosuppressives, usually for those with more severe manifestations like kidney disease. Sunscreen and skin creams containing corticosteroids may also be prescribed.