What Does Lupus of the Skin Look Like?

Reviewed on 3/29/2022

Illustration of a woman's face with a lupus
Symptoms of lupus on the skin include a red “butterfly rash” on the cheeks and nose, a scaly rash on sun-exposed areas of the body, circular skin lesions with distinct edges or lesions that look like psoriasis on sun-exposed skin, disk-shaped lesions, sores on the scalp and face, and hair loss.

Systemic lupus erythematosus (SLE) is a chronic autoimmune disease that causes the body’s immune system to mistakenly attack its own organs and tissues, causing inflammation and pain, commonly in the skin, joints, kidneys, and brain and may be fatal. When SLE affects the skin, it is called cutaneous lupus

There are three main types of lupus of the skin with varying symptoms: 

  • Acute cutaneous lupus (“acute skin lupus”)
    • Lesions occur when systemic lupus is active 
    • Looks like a red, raised rash on the cheeks and nose that resembles a butterfly (“butterfly rash”)
    • Rash can also appear on arms, legs, and body
    • Lesions are usually very sensitive to sunlight (photosensitive) 
    • Changes in skin color may occur, though scarring typically does not occur
  • Subacute cutaneous lupus (“subacute lupus”)
    • Red, raised, scaly rash on sun-exposed areas of the body
    • Circular skin lesions with distinct edges or lesions that look like psoriasis on sun-exposed skin
    • Lesions most often occur on sun-exposed areas of the arms, shoulders, neck, and body
    • The lesions can become discolored
    • Lesions are also photosensitive 
  • Chronic cutaneous lupus (“discoid lupus”)
    • Starts out as a red to purple, scaly, thick rash on the scalp, face, ears, and other sun-exposed areas
    • Disk-shaped, round lesions
    • Sores commonly occur on the scalp and face but may appear on other parts of the body 
    • Over time, skin may heal with discolored scarring 
    • Hair loss, if it affects the scalp 
    • May cause pain or itching 
    • Cancer can develop in discoid lesions that have been present for a long time

Other symptoms of systemic lupus erythematosus may include: 

How Is Lupus of the Skin Diagnosed?

Cutaneous lupus is diagnosed when a patient already has a diagnosis of systemic lupus erythematosus (SLE). 

In order to determine whether a skin rash or lesion is due to cutaneous lupus, a tissue sample of the skin will be taken (a biopsy), which will be examined under a microscope. 

What Is the Treatment for Lupus of the Skin?

Lupus is usually treated with medications to help manage symptoms, such as:

  • Anti-inflammatories and steroids 
  • Antimalarials (to help protect skin from rashes and UV light)
  • Biologics 
  • Immunosuppressives 
  • Anticoagulants 

Home treatment that may help patients manage symptoms of lupus include:

SLIDESHOW

Lupus Symptoms, Rash, and Treatment See Slideshow

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Reviewed on 3/29/2022
References
Image source: Getty Images

https://www.lupus.org/

https://www.uptodate.com/contents/epidemiology-and-pathogenesis-of-systemic-lupus-erythematosus?search=What%20Causes%20Lupus%3F&source=search_result&selectedTitle=1~150&usage_type=default&display_rank=1#H7

https://www.uptodate.com/contents/clinical-manifestations-and-diagnosis-of-systemic-lupus-erythematosus-in-adults?search=Lupus&source=search_result&selectedTitle=1~150&usage_type=default&display_rank=1#H2215760526

https://jamanetwork.com/journals/jamadermatology/fullarticle/1843885