- With Mayo Clinic rheumatologist
April Chang-Miller, M.D.
read biographyclose windowBiography of
April Chang-Miller, M.D.
April Chang-Miller, M.D.
Dr. April Chang-Miller is board certified in internal medicine and rheumatology and is a consultant in the Division of Rheumatology at Mayo Clinic in Arizona.
Dr. Chang-Miller's primary field is rheumatology with special interests in inflammatory joint diseases called seronegative spondyloarthropathies, such as ankylosing spondylitis and psoriatic arthritis. She also cares for patients with rheumatoid arthritis and polymyalgia rheumatica.
The New York City native is a graduate of the Yale School of Medicine. Dr. Chang-Miller joined the Mayo Clinic staff in Rochester, Minn., in 1991, and in 2002 she relocated to Mayo Clinic in Arizona. She is a fellow in the American College of Rheumatology and has been on the board of directors of the Arthritis Foundation North Central Chapter.
Symptoms (3)
- Lupus: Can it cause hair loss?
- Lupus: Can it cause hives?
- Livedo reticularis: When is it a concern?
Complications (1)
- Lupus: How does it affect the kidneys?
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Question
Lupus: Can it cause hives?
Does lupus cause hives?
Answer
from April Chang-Miller, M.D.
Lupus can cause hives, but this is uncommon. The exact cause of hives in lupus isn't clear. But it may be due to certain antibodies produced by some people with lupus. Sun exposure also may play a role. In addition, some of the medications used to treat lupus may cause side effects that include hives.
Individual hives usually last less than 24 hours. Individual hives that last longer than 24 hours may be due to urticarial vasculitis, a condition characterized by inflammation of the small blood vessels in the skin. Lupus is one cause of urticarial vasculitis.
Signs and symptoms of urticarial vasculitis include an itching and burning sensation in the affected skin. Unlike hives, wheals caused by urticarial vasculitis may leave behind a bruise. A doctor may confirm a diagnosis of urticarial vasculitis by a biopsy of the affected skin.
Treatment of hives may include:
- Antihistamines
- H-2 blockers (cimetidine, ranitidine)
- Corticosteroids
Treatment of urticarial vasculitis also may include antihistamines, H-2 blockers and corticosteroids, but used for a longer time than with simple hives. Aggravating factors, such as sun exposure, also may need to be controlled. In addition, treatment of lupus is important in controlling urticarial vasculitis.
Next questionLivedo reticularis: When is it a concern?
- Tassiulas I, et al. Clinical features and treatment of systemic lupus erythematosus. In: Firestein GS, et al., eds. Kelley's Textbook of Rheumatology. Philadelphia, Pa.: Elsevier, Inc.; 2010. http://www.mdconsult.com/das/book/body/196537603-2/0/1807/559.html?tocnode=55733259&fromURL=559.html . Accessed April 15, 2010.
- Stone JH, et al. Immune complex-mediated small-vessel vasculitis. In: Firestein GS, et al., eds. Kelley's Textbook of Rheumatology. Philadelphia, Pa.: Elsevier, Inc.; 2010. http://www.mdconsult.com/das/book/body/196350218-2/0/1807/642.html?tocnode=55733724&fromURL=642.html#4-u1.0-B978-1-4160-3285-4..10085-3--s0090_3187. Accessed April 15, 2010.
- Schur PH, et al. Mucocutaneous manifestations of systemic lupus erythematosus. http://www.uptodate.com/home/index.html. Accessed April 15, 2010.
- Cutaneous side effects from rheumatic drugs. Lupus Foundation. http://www.lupus.org/webmodules/webarticlesnet/templates/new_empty.aspx?articleid=468&zoneid=76. Accessed April 15, 2010.
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