Where does lupus erythematosus generally appear?

Written by Liu Li Ning
Rheumatology
Updated on January 14, 2025
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Lupus erythematosus can appear on various parts of the body. The most typical rash is the butterfly rash on the face, but it can also appear on other parts, such as discoid lupus, annular erythema, periungual erythema, and livedo reticularis. Additionally, systemic lupus erythematosus affects not only the skin and mucosa but can also involve the lungs, kidneys, heart, central nervous system, and other systems. Common manifestations include lupus nephritis and lupus pneumonia. The precise pathogenesis of systemic lupus erythematosus is still unclear. If the damage is confined to the skin and mucosa, immunomodulators such as hydroxychloroquine can be used for treatment. If important organs are involved, it generally requires long-term maintenance treatment with corticosteroids combined with immunosuppressants to control the progression of the disease.

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Written by Zhang Lin
Rheumatology and Immunology Nephrology
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Will the rash of lupus fade away?

Patients with lupus often experience recurrent, stubborn skin lesions on their hands or face, and some may even develop ulceration, atrophy, or scarring on top of the existing erythema. Most lupus patients exhibit erythema, centered around the bridge of the nose and appearing on the cheeks. The lesions are disc-like on both sides with generally clear boundaries, either flat or slightly raised, and are categorized as exudative inflammation. Depending on the severity of the inflammation, the erythema can range from light red, bright red to purple-red. In severe cases, localized edema resembling erysipelas may occur, and scaling and hyperpigmentation may appear as the inflammation subsides. Facial rashes generally resolve, and most rashes do not leave marks after resolution. If hyperpigmentation remains after the erythema has resolved, it suggests a good prognosis. However, erythema in other areas, such as acral erythema and reticular cyanosis, may last for varying durations depending on the patient's individual condition.

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Written by Zhang Lin
Rheumatology and Immunology Nephrology
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How is lupus treated?

The treatment of lupus erythematosus mainly involves the following aspects: Firstly, mild patients can be treated with antimalarial drugs, such as chloroquine or hydroxychloroquine, thalidomide, and low-dose corticosteroids; moderate active patients can receive individualized treatment with corticosteroids, and immunosuppressants may be used when necessary; for severe patients, corticosteroids are the preferred treatment, combined with immunosuppressants such as cyclophosphamide. Secondly, for lupus crisis patients, treatment can involve immunoglobulin, high-dose corticosteroid pulse therapy. Thirdly, biologics, such as anti-CD20 monoclonal antibodies, plasmapheresis, and autologous stem cell transplantation, are also used clinically. Medication for treating lupus erythematosus should be used under the guidance of a doctor, and self-medication should be avoided to prevent serious consequences.

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Written by Zhang Lin
Rheumatology and Immunology Nephrology
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Can lupus be cured?

Lupus erythematosus currently has no cure in clinical practice. However, an early diagnosis and treatment can significantly prolong the life expectancy of patients. Compared to the past, with standardized and effective individualized treatments, the 5-year survival rate can reach 95%, and the 10-year survival rate can reach 84%. However, the cause of lupus erythematosus is unclear, and no method can completely cure the disease. It is important to emphasize that there are already some medications available clinically that can alleviate the symptoms, allowing patients to live normal lives and work normally. Additionally, it is crucial not to resort to desperate measures by seeking random treatments or believing in folk remedies and secret family recipes shared by others. Such actions can not only delay proper treatment and waste money but also worsen the condition due to unclear formulations.

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Written by Zhang Lin
Rheumatology and Immunology Nephrology
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What should I do if lupus causes a cold and cough?

When patients with lupus erythematosus experience a cold and cough, we should first conduct a routine blood test to see if it is caused by an infection, and then treat the symptoms accordingly. If the patient has a cough with phlegm, we should first help the patient clear the phlegm to avoid choking. Patients with lupus erythematosus should not take medication at will. If medication is needed to treat the cold and cough, it should be used under the guidance of a doctor.

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Written by Liu Li Ning
Rheumatology
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What does the early rash of lupus look like?

The early characteristic rash of lupus erythematosus is typically a butterfly-shaped rash on the face. Other common presentations include palm and periungual erythema, discoid rash, nodular erythema, and livedo reticularis. If the rash is not notably itchy, it generally indicates lupus erythematosus. If there is significant itching, it may suggest the possibility of an allergic factor active in the disease. After immunosuppression, itchy rashes should be monitored for possible fungal infections. The specific pathogenesis of systemic lupus erythematosus is still unclear. If a patient exhibits the typical butterfly-shaped rash on the face, systemic lupus erythematosus should be highly suspected. Testing for antinuclear antibodies, and specifically for anti-Sm and double-stranded DNA antibodies, which represent a variety of autoantibodies, can diagnose systemic lupus erythematosus.