GoodRx / Maryann Mikhail, MD
Key takeaways:
- Lupus is an autoimmune disease that can affect the skin, joints, and internal organs.
- Skin rashes are common in lupus and are clues to the diagnosis.
- People who are diagnosed and treated earlier do better.
Lupus is an autoimmune condition that can affect your skin, joints, and internal organs. It can be hard to diagnose because its symptoms are often mistaken for other diseases. Symptoms range from mild and limited to the skin, to life-threatening and spread over the whole body. Recognizing the signs of lupus in the skin can lead to earlier diagnosis and treatment.
What is lupus?
Lupus is a condition that can cause inflammation in any part of the body. It’s autoimmune, meaning your immune system mistakenly attacks your body. We don’t know why this happens, but it’s likely a combination of your genetics and environment. Lupus can affect anyone, but people assigned female gender at birth are at greatest risk, especially during child-bearing ages (15 to 44). Certain ethnic groups of people are more affected than white people, such as those who are:
- Black
- Hispanic and Latino
- Asian
- Indigenous
The symptoms of lupus can be internal, external, or a combination of both. When inside organs are affected, it’s called systemic lupus erythematosus (SLE). If your skin, hair, or nails are affected, it’s called cutaneous lupus (CLE).
What is the first sign of lupus?
The first signs of SLE are:
- Feeling tired
- Joint pain
- Sensitivity to sunlight
- Muscle soreness
- Fevers
Skin symptoms are common in people with lupus. They affect 70% to 80% of people who have the condition. Skin issues are the first sign in 20% of people with lupus. Below, we discuss some of the most common early skin signs.
The classic lupus “butterfly” rash
Considered a telltale sign of lupus, this is a red rash — flat or raised — in a butterfly shape on the cheeks and the nose. Usually, there are no symptoms, but some people describe it as a little painful or itchy.
The sun-sensitive lupus rash on the face, chest, arms, and legs
People with lupus get flares of rashes in areas of skin exposed to the sun, like the chest or the arms. The rash can be red and scaly, or form ring shapes. It can be delayed from a few days to a few weeks after sun exposure. For some, the rash is itchy.
The discoid lupus rash
Discoid lupus is a thick, coin-shaped rash that can be red or dark. Plugged hair follicles (hair follicles clogged by thick skin) and scarring appear in sun-exposed areas. Some people feel mild itching or pain with these rashes.
Hair loss
This is a common symptom of SLE. Hair loss can be all over the scalp, patchy, or “lupus hair,” where the hair in the front and on the sides of the scalp are thin and fragile.
