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- Mayo Clinic: Lupus Symptoms
- National Institute of Arthritis and Musculoskeletal and Skin Diseases: Symptoms of Lupus
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Lupus: Early Signs and Symptoms
Systemic lupus erythematosus--better known as lupus or SLE--is an autoimmune disease affecting the skin, kidneys, lungs, joints and other body organs. The immune system protects the body from infectious agents. To do this, it has a system for recognizing your cells versus foreign material.
If you are experiencing serious medical symptoms, seek emergency treatment immediately.
With autoimmune disease, this recognition mechanism is askew and the immune system mistakenly attacks body tissues. Lupus is a health-related case of mistaken identity.
With so many organs potentially involved, lupus signs and symptoms are highly variable 1. Some common early signs and symptoms can help point toward a diagnosis of lupus 1.
Fatigue
Fatigue is an almost universal symptom of lupus.
In some people, this symptom becomes so severe that everyday functioning is a struggle.
No amount of sleep alleviates this persistent fatigue. In a 2010 article published in “Arthritis Care and Research,” Dr. D. Robinson Jr. and colleagues found that 87 percent of people with lupus reported fatigue as a frequent health issue.
- Fatigue is an almost universal symptom of lupus.
- In some people, this symptom becomes so severe that everyday functioning is a struggle.
Low-Grade Fever
Blotchy Red Skin on My Face
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Low-grade fevers are common in people with lupus. Some people may not be aware of the fevers as they come and go. The increased activity of the immune system in SLE underlies the presence of fever.
Joint Pain
The immune system often attacks the joints in people with lupus. This causes pain and possibly swelling.
Stiffness of the affected joints is common. Often, several joints are affected simultaneously.
- The immune system often attacks the joints in people with lupus.
Facial Rash
Early Staph Infection Symptoms
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Malar rash is a classic symptom of lupus 1. Redness is present across the bridge of the nose and the upper areas of the cheeks--those parts of the face that are most exposed when in the sun.
The malar rash of lupus is often described as a butterfly rash because the outline resembles the shape of a butterfly. In a 2010 article published in the “Indian Journal of Dermatology,” Drs. A. Kole and A. Ghosh reported that 80 percent of study participants seen in a rheumatology clinic for lupus exhibited a malar rash 1.
- Malar rash is a classic symptom of lupus 1.
- The malar rash of lupus is often described as a butterfly rash because the outline resembles the shape of a butterfly.
Body Rashes
People with lupus often have increased sensitivity to sun exposure. Rashes on sun-exposed surfaces such as the chest, shoulders, upper arms and hands may develop. Often the rash first appears or gets worse after being in the sun.
Raynaud's Phenomenon
People with lupus may exhibit Raynaud’s phenomenon--periodic spasms of the blood vessels of the fingers or toes. During a spasm, the blood vessels constrict, severely limiting blood supply to the affected fingers or toes.
The affected area typically turns white and often goes numb.
When blood supply returns, the area turns bright red. Cold temperature and stress often trigger an attack of Raynaud’s phenomenon.
- People with lupus may exhibit Raynaud’s phenomenon--periodic spasms of the blood vessels of the fingers or toes.
Hair Loss
Lupus may affect the skin of the scalp, causing hair loss. The hair loss from lupus is usually permanent.
Nose or Mouth Ulcers
Slow-healing ulcers in the nose or mouth are a possible early sign of lupus. The underlying cause is a local attack by the immune system.
Unintentional Weight Loss
Unintentional weight loss may be an early symptom of lupus. Although this symptom is not specific to lupus, if it is present with other characteristic symptoms, suspicion for SLE increases 1.
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References
- Mayo Clinic: Lupus Symptoms
- Lupus Foundation of America: What Are the Symptoms of Lupus
- Johns Hopkins Arthritis Center: What Are the Symptoms of Lupus
- National Institute of Arthritis and Musculoskeletal and Skin Diseases: Symptoms of Lupus
- Centers for Disease Control and Prevention. Systemic lupus erythematosus (SLE). Updated October 17, 2018.
- Lupus Foundation of America. Lupus facts and statistics. Updated October 6, 2016.
- Centers for Disease Control and Prevention. Lupus in women. Updated October 17, 2018.
- Maidhof W, Hilas O. Lupus: an overview of the disease and management options. P T. 2012;37(4):240-9.
- Lupus Foundation of America. Lupus facts and statistics. Updated October 6, 2016.
- Lupus Foundation of America. About cutaneous lupus. Updated July 12, 2013.
- Barbhaiya M, Costenbader KH. Environmental exposures and the development of systemic lupus erythematosus. Curr Opin Rheumatol. 2016;28(5):497-505. doi:10.1097/BOR.0000000000000318
- Grönhagen CM, Nyberg F. Cutaneous lupus erythematosus: An update. Indian Dermatol Online J. 2014;5(1):7-13. doi:10.4103/2229-5178.126020
- Johns Hopkins Lupus Center. Lupus-specific skin disease and skin problems.
- Centers for Disease Control and Prevention. Lupus symptoms. Updated October 17, 2018.
- Harley JB, Chen X, Pujato M, et al. Transcription factors operate across disease loci, with EBNA2 implicated in autoimmunity. Nat Genet. 2018;50(5):699-707. doi:10.1038/s41588-018-0102-3
- Centers for Disease Control and Prevention. Diagnosing and treating lupus. Updated October 17, 2018.
- Lupus Foundation of America. Medications used to treat lupus. Updated July 12, 2013.
- Navarrete-navarrete N, Peralta-ramírez MI, Sabio-sánchez JM, et al. Efficacy of cognitive behavioural therapy for the treatment of chronic stress in patients with lupus erythematosus: a randomized controlled trial. Psychother Psychosom. 2010;79(2):107-15. doi:10.1159/000276370
- Greco CM, Nakajima C, Manzi S. Updated review of complementary and alternative medicine treatments for systemic lupus erythematosus. Curr Rheumatol Rep. 2013;15(11):378. doi:10.1007/s11926-013-0378-3
- Lupus Foundation of America. Smoking and lupus: It's never too late to quit.
- Zhang L, Fu T, Yin R, Zhang Q, Shen B. Prevalence of depression and anxiety in systemic lupus erythematosus: a systematic review and meta-analysis. BMC Psychiatry. 2017;17(1):70. doi:10.1186/s12888-017-1234-1
- Olesińska M, Saletra A. Quality of life in systemic lupus erythematosus and its measurement. Reumatologia. 2018;56(1):45-54. doi:10.5114/reum.2018.74750
- Maidhof W, Hilas O. Lupus: an overview of the disease and management options. P T. 2012;37(4):240-9.
- Lupus Foundation of America. How Lupus Affects the Skin.
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Writer Bio
Dr. St. John is a medical writer and editor with more than 15 years experience in the field. She is a former medical officer for the Centers for Disease Control and Prevention.