The following symptoms and complaints may indicate lupus erythematosus:
Systemic lupus erythematosus (SLE)
Leading symptoms – skin manifestations.
- Skin lesions (75% of patients with SLE have skin lesions, which are even symptomatic in 25% of cases):
- Acute cutaneous lupus erythematosus (ACLE).
- Butterfly-shaped erythema (butterfly erythema; erythema (areal redness of the skin)) on the face (starting from the bridge of the nose symmetrically onto the zygomatic and cheek regions); occurs in up to 80% of affected individuals; which is exacerbated by sunlight (photosensitivity)
- Maculo-papular exanthema (patchy nodular rash), generalized or mainly on the chest and back.
- Especially on the fingers blotchy, reddened skin lesions.
- Nail symptoms (frequency of nail involvement: 20%):
- Koilonychia (spoon nails) – nail change with trough-shaped depression and increased brittleness of the nail plate.
- Red lunula (red nail moon)
- Teleangiectasias (dilation of skin vessels) and hemorrhages (hemorrhages) at the nail fold (splinter hemorrhages of the nails, i.e. small streaky brown. Discolorations)
- Acute cutaneous lupus erythematosus (ACLE).
- Raynaud’s symptomatology – vasoconstriction occurring mainly in the fingers and toes with temporary reduced blood flow.
- Diffuse hair loss
Skin symptoms in systemic lupus erythematosus can be very diverse.The musculoskeletal system is affected in about 90% of patients with SLE. General symptoms
- General feeling of illness (possibly also fatigue/fatigue).
- Fever
- Unwanted weight loss
- Nausea (nausea), diarrhea (diarrhea).
- Generalized lymphadenopathy (lymph node enlargement).
- Arthralgia (joint pain), often in the small joints.
- Arthritides (inflammation of the joints)
- Myalgia (muscle pain)
- Cephalgia (headache)
- Epileptiform seizures
- Psychotic states
- Cognitive disorders
- Acute confusion
- Movement disorders
- Peripheral neuropathies (diseases of the peripheral nervous system).
- Pleurisy (inflammation of the pleura)
- Endocarditis (inflammation of the inner lining of the heart)
- Pericarditis (inflammation of the pericardium)
- Glomerulonephritis (inflammation of the renal corpuscles) [predictor of outcome of SLE].
- Sjögren’s syndrome (group of sicca syndromes) – autoimmune disease from the group of collagenoses leading to chronic inflammatory disease of the exocrine glands, most commonly the salivary and lacrimal glands; typical sequelae or complications of sicca syndrome are:
- Keratoconjunctivitis sicca (dry eye syndrome) due to lack of wetting of the cornea and conjunctiva with tear fluid.
- Increased susceptibility to caries due to xerostomia (dry mouth) due to reduced salivary secretion.
- Rhinitis sicca (dry nasal mucous membranes), hoarseness and chronic cough irritation and impaired sexual function due to disruption of mucous gland production of the respiratory tract and genital organs.
- Blood count changes such as anemia (anemia), leukocytopenia (decreased number of leukocytes/white blood cells compared to the norm), lymphopenia (decreased number of lymphocytes/white blood cells compared to the norm), thrombocytopenia (decreased number of platelets/platelets compared to the norm).
- Splenomegaly (spleen enlargement).
Discoid lupus erythematosus (DLE)
Discoid lupus erythematosus (DLE) usually shows a chronic course – therefore it is called chronic discoid lupus erythematosus (CDLE). Leading symptoms – skin manifestations
- Disc-shaped, sharply demarcated erythema with firmly adherent scales with the tapestry nail phenomenon (= erythematous plaques with follicular hyperkeratoses); occurring mainly on the light-exposed areas such as forehead, cheeks, shoulders, neck, etc.; heal with scarring.
- Dimpled scars
- Teleangiectasia – dilation of skin vessels.
- Patchy hypo/hyperpigmentation
- Narrow alopecia (irreversible alopecia; hairlessness; pseudopelade).
- Erythema, erosions on the oral mucosa.
The skin symptoms show increased sensitivity to touch. No general symptoms are present. Approximately 5% of patients with DLE, initially without systemic organ involvement, develop SLE during the course of the disease.
Subacute cutaneous lupus erythematosus (SCLE)
Leading symptoms – skin manifestations
- Disc-shaped, sharply demarcated erythema with firmly adherent scales with the tapestry nail phenomenon; occurring mainly on light-exposed areas such as the forehead, cheeks, shoulders, neck, etc.; scarless healing.
- Teleangiectasia – expansion of skin vessels.
- Patchy hypo/hyperpigmentation
- Erythema (redness of the skin), erosions (superficial substance defects confined to the epidermis, without scarring) on the oral mucosa
Skin manifestations show increased sensitivity to touch. General symptoms – compared to systemic lupus erythematosus much milder pronounced.
- Arthralgia (joint pain), often in the small joints.
- General feeling of illness
- Fever
- Myalgia (muscle pain)
Lupus erythematosus profundus
Leading symptoms – skin manifestations
- Painful nodularity localized to the face, upper arms/thighs, and buttocks; livid surface; may ulcerate and heal with scarring
Juvenile systemic lupus erythematosus
Only differences in symptomatology and course are listed below:
- Fever, skin symptoms, and organ involvement (hemolytic anemia, encephalopathy (brain disease), renal insufficiency (kidney weakness to failure) (more common than in adults)
- Pneumonia / pneumonia (cause of death in about 50% of cases).
- Cutaneous involvement (vasculitis), nephropathy (kidney disease) or seizures are (rare at the onset of the disease).
- Joint manifestations, photosensitivity (increased sensitivity of the skin to light), sicca symptomatology (symptomatology of dry eyes and/or a dry mouth), discoid lupus (rare at onset and later in the course of the disease)