Lupus affects multiple systems in your body, leading to many observable and visible symptoms. Identifying these symptoms may help you obtain a diagnosis or know when you’re experiencing a flare.
Lupus is an autoimmune disease that affects more than 1.5 million people in the United States, according to the Lupus Foundation of America.
Typically, your immune system protects your body against foreign invaders like viruses and bacteria. With lupus, your immune system mistakenly attacks your body and damages healthy tissues and organs.
Keep reading to learn more about symptoms to expect from lupus and how to spot them.
People with lupus often develop flu-like symptoms. They feel extremely tired. They have headaches and a fever, and their joints become swollen or painful.
Because similar symptoms can occur with other diseases, lupus can be challenging to diagnose. Its vague symptoms are also why lupus is sometimes called “the great imitator.”
Lupus that affects the skin (cutaneous lupus) comes in different forms and causes various types of rashes.
Malar (butterfly) rash
When systemic lupus (SLE) flares up, you may notice a sunburn-like rash on your face. This “butterfly” rash is a sign of acute cutaneous lupus (ACLE). The rash is distinctive for its butterfly-like appearance. It spreads across the nose and fans out on both cheeks.
This rash can also emerge on other parts of the body, especially those exposed to the sun, such as the arms, legs, and trunk. The ACLE rash is very sensitive to light.
Discoid rash
Discoid lupus occurs in people with chronic cutaneous lupus (CCLE). It produces a coin-shaped, red, scaly rash on the cheeks, nose, and ears. The rash doesn’t itch or hurt, but once it fades, it may leave the skin discolored.
If the rash is on the scalp, hair loss may occur. Sometimes, hair loss may be permanent.
Livedo reticularis
Livedo reticularis, or mottled skin, describes a blue or purple lacy pattern on the skin. It’s due to decreased blood flow in the blood vessels under your skin. It most often appears on your legs.
Ring-like rash
In people with subacute cutaneous lupus (SCLE), the rash can look like scaly red patches or ring shapes. This rash usually appears on parts of the body that are often exposed to the sun, such as the arms, shoulders, neck, chest, and trunk.
Having SCLE can make you more sensitive to the sun, so you need to be careful when going outside or sitting under fluorescent lights.
Some people with lupus experience hair loss. This could be due to inflammation that affects your hair follicles or discoid sores that leave scars and damage hair follicles.
Hair loss due to inflammation may be temporary, but hair loss due to discoid scarring is
Lupus may affect hair follicles anywhere on your body, including your eyebrows, eyelashes, and facial hair.
Lupus can affect your nails in several ways,
- thinning or thickening
- pitting
- bands or lines on the nail
- swollen skin around the nail
- thickening of the skin under the nail
- discoloration
- visible blood vessels around the nail
These changes sometimes result from nail infections that develop due to the immune-suppressing effects of lupus medications.
Joint pain is one of the
- swelling
- discoloration
- skin that’s warm to the touch
Lupus joint pain typically affects smaller joints in your hands and feet first.
Lupus can also weaken muscles, especially in the pelvis, thighs, shoulders, and upper arms. Additionally, the disease can trigger carpal tunnel syndrome, which leads to pain and numbness in the hands and fingers.
Lupus can affect your eyes in several ways, such as causing a malar rash on the skin around your eyes or dry eyes. Other visible eye symptoms may
- swelling around one or both eyes (often seen in DLE)
- swollen eyelids
- scaly rash on the eyelids
- episcleritis, which can look like pink eye
Raynaud’s phenomenon occurs when constriction of small blood vessels limits blood flow to your extremities, particularly your fingers and toes. This causes numbness and skin color changes in the affected area.
In people with lupus, this may be
Red blood cells transport oxygen-rich blood from the heart and lungs to the rest of the body. In lupus, your immune system can damage healthy red blood cells, causing anemia.
Having too few red blood cells can lead to symptoms such as fatigue, shortness of breath, dizziness, and a yellowish color to the skin and eyes (jaundice).
Some people with lupus have another problem with their blood. Typically, blood clots form when there’s an injury to prevent the body from bleeding too much. In lupus, thrombosis may occur, causing clots to form where they’re not needed.
Lupus often attacks the nerves, which carry messages from the brain to the rest of the body. This damage can lead to a range of symptoms, including:
- headaches
- confusion
- vision problems
- changes in mood
- dizziness
- numbness
When lupus attacks the lungs, it can cause trouble breathing. If the membrane around the lungs becomes inflamed (pleurisy), it puts pressure on the lungs, making breathing painful.
Lupus can also lead to pulmonary hypertension, a form of high blood pressure in which the blood vessel connecting the heart to the lungs thickens. Because less blood can travel from the heart to the lungs to pick up oxygen, the heart has to work much harder to keep up.
Among the many organs that lupus attacks are the kidneys, which regularly filter blood and remove waste from the body.
As the kidneys are damaged, fluid begins to build up in the body. One of the first symptoms of lupus nephritis is edema, or swelling due to fluid buildup in the legs, ankles, and feet. Lupus nephritis can eventually lead to kidney failure and other severe complications.
Lupus affects multiple systems in your body, causing a wide range of symptoms. Many symptoms are nonspecific, meaning they could be mistaken for a different condition.
Skin rashes and joint pain are among the most common visible symptoms. But lupus can also affect your eyes, nails, lungs, kidneys, and nerves.
Being able to identify patterns of lupus symptoms may help you and a doctor get closer to a diagnosis.