What Does Lupus of the Skin Look Like?

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: 

• Extreme fatigue 
• Joint pain or swelling 
• Swelling in the hands, feet, or around the eyes
• Fever
• Headache
• Sensitivity to light 
• Chest pain when inhaling deeply caused by inflammation in the lining of the lungs
• Sores in the mouth or nose
• Arthritis in two or more joints, plus swelling or tenderness
• Seizures or other nerve problems
• Fingers and toes turning white or blue and feeling numb when exposed to cold or stress (Raynaud’s disease)
• Weight loss
• Muscle pain
• Blood clots, which can lead to stroke or seizures
• Gastrointestinal problems
• Respiratory problems
• Neurologic and psychiatric problems
• Blood abnormalities 
• Swollen lymph nodes
• Eye problems
• Excess protein in the urine