The role of the immune system is to fight off foreign invaders, such as viruses and bacteria. In a person with lupus, the immune system mistakes healthy body tissues for harmful substances.
Lupus is a chronic condition, which means that it lasts for months to years. To date, there is no cure for lupus, but a doctor can help a person control and manage their symptoms.
In this article, learn more about lupus symptoms and how they appear.
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Image credit: Mohammad2018, 2019.
Image credit: Leonard C. Sperling, M.D., COL, MC, USA, Department of Dermatology, Uniformed Services University, 2009
Joint swelling and pain
Image credit: Intermedichbo, 2010
The immune system’s attack can affect many different body parts and systems. As a result, lupus can cause a wide variety of symptoms that may be different from person to person.
The symptoms of lupus may appear or get worse during flares. Once a flare is over, a person may have mild or no symptoms for weeks, months, or even years.
A person with lupus may notice some of the following symptoms.
Many people with lupus experience a red or purplish rash that extends from the bridge of the nose over to the cheeks in a shape that resembles that of a butterfly.
The rash may be smooth, or it may have a scaly or bumpy texture. It can look like a sunburn.
The medical term for this type of rash is a malar rash. Other conditions can cause a malar rash, however, so this symptom alone is not enough to indicate lupus. Other conditions that cause a malar rash include:
In some cases, a doctor may treat the malar rash with prescription creams or ointments. These medications may include steroids to minimize inflammation. In other cases, a doctor may prescribe medicines that help stop immune system activity.
Sores or red patches on the skin
Lupus can cause two main types of lesion or sore:
- Discoid lupus lesions, which are thick and disk-shaped. They often appear on the scalp or face and can cause permanent scarring. They may be red and scaly, but they do not cause pain or itching.
- Subacute cutaneous lesions, which may look like patches of scaly skin or ring-shaped sores. They usually appear on areas of skin that get exposure to the sun, such as the arms, shoulders, and neck. They do not cause scarring.
Both types of lesion are photosensitive, which means that they are highly sensitive to sunlight.
People who have these types of lesion should avoid being out in the sunlight as much as possible, use sunscreen, wear sun-protective clothing, and limit or avoid exposure to fluorescent light.
Hair loss is a possible symptom of lupus.
- Discoid lupus sores on the scalp or other areas can cause hair to fall out temporarily. If the sores produce a scar, hair loss can be permanent in that area.
- Severe lupus can cause temporary hair loss if there is inflammation of the skin. The hair usually grows back when a person takes medication to manage the symptoms.
- Some medications that treat lupus can cause hair loss. For example, some steroids and immunosuppressants can cause the hair to become brittle and break, leading to hair loss.
Joint swelling and pain
One of the most common symptoms of lupus is joint problems. Lupus may cause swollen, tender, stiff, or warm joints.
These issues usually affect the extremities, including the fingers, toes, wrists, knees, and ankles. Although lupus is not a type of arthritis, the inflammation that it causes can result in symptoms of arthritis.
A person with lupus may have photosensitivity, which is a sensitivity to ultraviolet (UV) light. They may notice that they get sunburned more easily than other people.
The sun can also trigger the development of skin lesions, such as a butterfly rash or discoid lupus.
Cold, blue, or pale hands or feet
Some people with lupus experience Raynaud’s phenomenon, which affects the blood vessels in the fingers, toes, hands, or feet.
Raynaud’s phenomenon makes the blood vessels in the extremities constrict, which turns the extremities blue or pale, as well as causing tingling, numbness, and pain.
A person may notice this reaction when they are in cold temperatures or under stress.
A person may be able to manage their Raynaud’s symptoms by avoiding cold temperatures, dressing warmly in gloves, socks, and boots, and using stress management techniques, such as meditation and relaxation.
Dry, red, or irritated eyes and vision problems
Lupus can affect the eyes and the area around the eyes in several ways:
- The retina may have an inadequate blood supply, leading to vision loss.
- Discoid lupus lesions can appear on the eyelids.
- The tear glands may not produce enough tears, leading to dry eyes.
- The outer layer of the eye may become inflamed and red, which is an effect called scleritis.
Other possible symptoms of lupus include:
- chest pain when taking a deep breath
- severe fatigue
- anemia (low red blood cell count or low blood volume)
- weak muscles or reduced strength
- carpal tunnel syndrome
- tendonitis (irritation of a tendon)
- kidney problems
- heart problems
Types of lupus
Doctors categorize lupus into four different types. These types share common symptoms but have different causes.
- Systemic lupus erythematosus is the most common form of lupus. It can affect many different organs and body systems.
- Cutaneous lupus erythematosus only affects the skin. It may cause discoid sores, subacute cutaneous lesions, and a butterfly rash. It does not cause joint pain, anemia, or any other symptoms that do not relate to the skin.
- Drug-induced lupus erythematosus can happen when a person takes certain prescription medicines. Its symptoms are similar to those of systemic lupus, but they usually go away when the person stops taking the medication.
- Neonatal lupus can occur when a person has lupus during pregnancy, causing their baby to develop lupus-like symptoms. Antibodies can cause a skin rash, low blood cell counts, or liver problems in the infant. These symptoms usually go away without treatment within a few months. Most people with lupus have babies without these problems.
A doctor may recommend several tests to diagnose lupus.
To diagnose lupus, a doctor will:
- discuss a person’s symptoms and medical history
- perform blood tests to look for particular antibodies and proteins, check blood cell counts, and measure clotting ability
- urine tests to check kidney function
- a biopsy of the skin, kidneys, or both
There is no single test that can diagnose lupus. Instead, doctors must look at the results of several different tests and consider the person’s symptoms.
They may also need to rule out other health conditions that can cause similar symptoms.
Treatment for lupus focuses on managing lupus flares and preventing them when possible.
Treating symptoms promptly can help avoid complications that can damage the body’s organs and systems. A person may need to take medications and see their doctor regularly.
Some medications that doctors recommend to help with lupus symptoms include:
- nonsteroidal anti-inflammatory drugs (NSAIDs) to reduce swelling and pain in the joints and muscles
- steroids to fight inflammation
- antimalarial drugs, which help decrease the immune system’s activity and reduce photosensitivity
- immunosuppressive drugs, which control the overactive immune response
- anticoagulants to help prevent blood clots
A person can work with their doctor to decide which medications and treatment options are best for them.
Some people may wish to use alternative treatments to help manage their lupus symptoms. While there is no conclusive evidence to confirm that any alternative treatments work, some people may find that they help with certain symptoms.
Before trying any alternative treatment, it is important to talk to a doctor. Some of these treatments may interfere with other medications. In addition, a person should never replace the medications that their doctor prescribed them with alternative treatments.
With proper treatment, many people who have lupus can live full, active lives. However, it is vital that they see a doctor regularly and follow an individualized treatment plan to avoid serious complications of the disease.
Dealing with a chronic disease can be challenging. People with lupus may wish to connect with others who have the condition for emotional support and encouragement.
The Lupus Foundation of America list their support groups by state, and there are other lupus support groups in some states. The Lupus Research Alliance also have an online community forum for people with lupus and their loved ones.