Systemic Lupus Erythematosus:
Information for adults

More than 90% of people with systemic lupus erythematosus have skin symptoms. The most common locations for the skin lesions of systemic lupus erythematosus include:

• Face, especially cheeks and nose
• Sun-exposed skin on arms, backs of hands, upper chest, and upper back due to increased sensitivity to sunlight (photosensitivity)
• Fingers and fingernails
• Mouth or nose
• Scalp

The classic skin finding in systemic lupus erythematosus is the butterfly rash (malar blush). Redness across the cheeks and bridge of the nose can occur after sun exposure and may appear as much as several weeks before other symptoms develop.

A rash can develop in sun-exposed skin (photo-distribution), especially on the backs of the hands and fingers. This rash, which appears as red, scaly patches, can also affect the arms and trunk. 

The skin around fingernails (nail folds) can be red and inflamed, and tiny, dilated blood vessels (telangiectasia) may be seen. In addition, people may develop Raynaud phenomenon, in which the fingers (and sometimes toes) turn pale and numb after exposure to cold temperatures.

Small, painless ulcers can develop in the nose or, more commonly, in the mouth, especially on the roof of the mouth. 

When lupus affects the scalp skin, you may notice hair loss. It may be patchy, or there may be thinning across the scalp, especially at the temples.

In addition to the skin lesions of lupus, people may have:

• Joint pain or swelling, especially in hands, wrists, and knees
• Blood problems, including anemia and clotting disorders
• Kidney disorders
• Lung problems, such as painful breathing
• Seizures or other brain disorders
• Swollen lymph glands
• Fever
• Fatigue