Lupus Rash

What is a lupus rash?

Skin rashes are a common sign of lupus, an autoimmune disease. A butterfly-shaped rash on your face — called a malar rash — often occurs. This rash reaches across your nose, from cheek to cheek, in a shape that resembles a butterfly.

In addition to the malar rash, lupus skin rashes can appear anywhere on your body. Certain types of lupus cause distinct lupus skin rashes.

Lupus gets its name from the facial rash. Thirteenth-century physician Rogerius Frugardi thought the lupus face rash resembled the markings of a wolf’s face or bite. He named the disease lupus, which means wolf in Latin.

What is cutaneous lupus erythematosus?

An estimated 2 out of 3 people with lupus develop a skin disease called cutaneous lupus erythematosus (CLE). The word “cutaneous” means skin. People with CLE develop skin rashes or sores, typically on sun-exposed parts of their body.

Some people have CLE alone, while others have CLE along with a different type of lupus. In about 1 in 5 people first diagnosed with CLE, the disease progresses to systemic lupus erythematosus (SLE). SLE is the most common type of lupus.

What are the types of lupus skin rashes?

There are different types of CLE, each with different skin rashes. Types of CLE include:

• Discoid lupus erythematosus (DLE).
• Subacute cutaneous lupus erythematosus (SCLE).
• Acute cutaneous lupus erythematosus (ACLE).

What is a discoid lupus rash?

Discoid lupus erythematosus (DLE) is the most common form of CLE. It’s also called chronic cutaneous lupus.

A discoid lupus rash typically appears on your face and scalp, but it can affect any part of your body. Discoid lesions on your scalp may cause temporary or permanent hair loss.

A discoid lupus rash typically:

• Has circular, coin- or disk-shaped red patches that are thick and scaly.
• Doesn’t itch or cause pain.
• May scar or discolor skin (lighter or darker).

Chronic discoid lupus rashes or sores may put you at risk for skin cancer. Discoid sores on your lips or inside of your mouth may develop a type of skin cancer called squamous cell carcinoma.

In rare instances, a person with discoid lupus also develops chilblain lupus erythematosus. This condition causes painful, purple skin patches that worsen in cold temperatures.

What is a subacute cutaneous lupus erythematosus (SCLE) rash?

SCLE rashes tend to develop on parts of your body that get a lot of sun, such as your arms, shoulders, chest and neck. The word “subacute” refers to the fact that the rash comes on somewhat quickly and isn’t present all the time.

The red, circular lupus rash:

• Connects to form interlocking circles.
• Isn’t generally painful or itchy.
• Won’t scar but might lighten or darken your skin.

What is an acute cutaneous lupus erythematosus (ACLE) rash?

ACLE causes the facial butterfly rash (malar rash). You may also have rashes on your forehead, arms, legs or other parts of your body. These other rashes don’t necessarily appear in a butterfly shape.

ACLE rashes occur when you have a lupus flare-up. This means the disease is active, causing symptoms.

When you have a butterfly rash, people may think that you’re flushing, blushing or have a bad sunburn. The rash may be flat, raised or scaly. It’s sometimes itchy but generally isn’t painful.

Rarely, ACLE also causes these problems:

• Canker sores (painful sores in your mouth).
• Hives (raised, painful bumps).
• Temporary hair loss.

What causes a lupus face rash or other lupus rashes?

Lupus occurs when cells in your immune system that typically fight off infections turn against your body and attack healthy cells. Inflammation throughout your body causes symptoms like lupus rashes, joint pain, extreme fatigue and fever.

Exposure to ultraviolet (UV) light from the sun or artificial light sources may bring on a lupus rash. Rashes occur when immune cells in your skin react to UV light sources, releasing chemicals that inflame your skin. This type of reaction indicates that your skin is photosensitive. UV exposure brings on or worsens skin problems for as many as 7 in 10 people with lupus.

How is a lupus rash treated?

A dermatologist (doctor specializing in skin) treats lupus skin rashes. Treatments may include:

• Topical steroids applied to your skin.
• Antimalarial drugs such as hydroxychloroquine (Plaquenil®).

How long do lupus rashes last?

Lupus rashes can last for days or weeks. Redness and skin discoloration may take longer to go away. Scars are often permanent, although they may fade over time or with treatments.

How can I prevent a lupus rash?

Lupus treatments like immunosuppressants can keep the disease in check, lowering your risk of developing a lupus rash. You can also take these steps to protect yourself from light exposure:

• Apply a broad-spectrum, SPF 30 sunscreen daily even when indoors. Reapply sunscreen every four hours.
• Avoid going outside when the sun’s rays are strongest, between 10 a.m. and 4 p.m.
• Wear a wide-brimmed hat (preferably one with SPF protection), tightly woven clothes, long sleeves and large sunglasses when outdoors.
• Don’t use tanning beds.
• Use lower-intensity lightbulbs at home and ask your employer to install them at your workplace.
• Put up UV-protective window coverings at home and work.
• Apply UV-protective window films to your car windows. (Be sure to follow your state laws).
• Move your workspace away from windows.

When should I call my healthcare provider about a lupus face rash?

You should call your healthcare provider if you experience lupus rashes that:

• Appear on your lip or inside of your mouth.
• Cause pain or itch.
• Linger for weeks or get worse despite treatment.

What questions should I ask my healthcare provider?

You may want to ask your healthcare provider:

• What type of lupus rash do I have?
• What’s causing the lupus rash?
• How should I treat the lupus rash?
• What steps can I take to prevent scarring?
• What steps can I take to prevent a future lupus rash?
• Should I look out for signs of complications?

A note from Cleveland Clinic

Lupus skin rashes are a common disease symptom of cutaneous lupus. A butterfly rash (malar rash) on the face affects many people with lupus, but lupus rashes can appear anywhere on your body. Avoiding UV light exposure can lessen your chances of developing a lupus skin rash. It can also prevent the flare-up of other lupus symptoms like fatigue and joint pain. Your healthcare provider can help you find the best treatments to prevent and treat lupus rashes.