It is a disease with many manifestations, and each person's profile or list of symptoms may be different. Lupus can mimic other diseases, such as multiple sclerosis and rheumatoid arthritis, making it difficult to diagnose by GPs as they see few cases of lupus and thus are not alert to its possibility. Moreover, a careful review of the patient's entire medical history is necessary, coupled with analysis of results obtained from tests relating to their immune status to provide accurate diagnosis. Only by comprehensive examination and consideration of symptoms and their history can a diagnosis be achieved. The goal of the treatment is to control the symptoms and the disease so that the patient can lead as normal a life as possible.
Time is sometimes necessary to observe the course of the disease.
As a consequence such patients are frequently categorised as hypochondriacs. The American Rheumatism Association criteria has provided the benchmark for the classification of lupus for the last 20 years. Many thousands of lupus patients passing through St Thomas' Hospital have led Dr Graham Hughes to offer the following 14 criteria aimed more towards diagnostic help and not to classification. Headache, cluster headache and migraine can be encountered and a strong history of teenage migraine may be of lupus significance, either at that time or subsequently. Not only are they susceptible to insect bites but often reactions are severe and prolonged - the skin is a major organ affected by lupus.