What is lupus?
One common experience with lupus is skin problems, and this is because there are specific types of skin-related lupus. Many people develop a lupus rash signaling one of these variations. Here’s what you need to know about how lupus affects the skin and when to see a doctor.
Lupus is a long-term condition that affects several different parts of the body. The symptoms of lupus range from mild to serious, one of which is skin rashes. There are several types of lupus, so symptoms vary depending on which kind you have. Some forms of lupus only affect the skin, while others may cause symptoms all over the body.
Skin lupus, or cutaneous lupus, is an autoimmune disorder that causes your immune system to attack healthy skin cells. These attacks then damage your skin. You can either have skin lupus alone or as a part of systemic lupus erythematosus (SLE). This is the most severe form of lupus affecting the skin and other body parts, like your joints, brain, heart, and lungs.
There are three kinds of skin lupus:
- Acute cutaneous lupus. This causes a butterfly-shaped lupus rash that spreads across your nose and cheeks and looks like a sunburn. It’s called a malar rash. The rash usually appears after you’ve been out in the sun and may show up on your arms, legs, and neck. This type of skin lupus is often associated with SLE.
- Subacute cutaneous lupus. You may develop a rash after exposing skin like your trunk, neck, arms, and shoulders to direct sunlight. With this kind of lupus, you may develop lesions, sores, or a scaly rash.
- Chronic cutaneous lupus. This type is also called discoid lupus, as it usually causes round sores to appear on your face or scalp. These can cause your skin to change colors or leave scars.
Who is most at risk for lupus?
Lupus is complicated because doctors and researchers still don’t know what causes it. While anyone can be affected by lupus, research suggests that some people are more likely to get it than others:
- Women between the ages of 15 and 44
- African American, Hispanic, Asian, and Native American women in the U.S.
- People of other non-European descent
Even though doctors aren’t sure what causes the different types of lupus, they think there are several factors, including genetics, hormones, and your environment.
What are the signs and symptoms of a lupus rash?
Since there isn’t just one kind of lupus, there isn’t just one kind of lupus rash. Some symptoms of skin lupus include:
- Thick, scaly patches that can be round or disc-shaped. These patches are usually found on your ears, face, or scalp. They’re often raised. The patches can sometimes leave scars on your skin, so it’s important to get treatment.
- A red, scaly rash on your upper back, neck, or chest.
- Ring-shaped or circular sores.
- A butterfly rash lasting anywhere from a few hours to a few days.
- A rash with hard, painful growths under the skin.
General symptoms of lupus include:
- Photosensitivity, or sensitivity to light and sunlight
- Alopecia, or hair loss
- Pain in your joints and muscles
- Extreme fatigue or feeling tired all the time, no matter how much rest you get
- Oral or nasal ulcers and mouth sores
- Reynaud’s disease, when your fingers and toes turn blue or white when cold or stressed
- High temperature and fever
If you have a rash you suspect might be lupus, along with any of these other symptoms, you should seek treatment from your doctor.
How is lupus diagnosed?
It can be tricky to diagnose lupus since there are many different symptoms, and they vary from one person to the next. There is no single test that can detect lupus, either.
When you visit your doctor, they will give you a physical exam and look for the typical signs and symptoms of lupus. You need at least 4 of the 11 most common symptoms to be diagnosed with lupus. Your doctor may also try a variety of tests to see if any other conditions can be ruled out.
When it comes to skin lupus, your doctor may order a biopsy of your lupus rash. They will take a small piece of the skin and analyze it under a microscope to check for common features of lupus. Besides the biopsy, your doctor may also ask for blood and urine tests. Most people with lupus test positive for antinuclear antibodies, but this alone can’t diagnose lupus.
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How is lupus treated?
There isn’t currently a cure for lupus, but there are ways to live with it and control your symptoms. Treatment depends on the kind of lupus that you have and how serious your symptoms are.
To help with your lupus rash, your doctor may prescribe a corticosteroid that you can take in pill form or apply directly to your skin. This helps reduce inflammation and clear up your skin. To help prevent flare-ups, your doctor may tell you about protecting your skin from the sun or lifestyle changes you might need to make.
Other common treatments for lupus are:
- Anti-inflammatory medications, including ibuprofen
- Hydroxychloroquine to fight fatigue and skin and joint problems
- Antimalarial medicine
- Medicine to strengthen the immune system
To help manage your symptoms, you should protect yourself from the sun, such as wearing at least SPF 50 sunscreen and putting on a hat when you go out. Try to keep active to maintain good overall health, but don’t push yourself if you become overly tired. Doctors also suggest that those with lupus shouldn’t smoke.
American Academy of Dermatology Association: "Lupus and Your Skin: Diagnosis and Treatment.", "Lupus and Your Skin: Signs and Symptoms."
Lupus Foundation of America: "Lupus and the skin."
Mount Sinai: "Systemic lupus erythematosus."
NHS inform: "Lupus."
University of Utah Health: "Skin Lupus (Cutaneous Lupus)."
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