If you have lupus (systemic lupus erythematosus, or SLE), you may be extremely tired, have skin rashes, or have joint pain. If the disease is more serious, you may have problems with your kidneys, heart, lungs, blood, or nervous system.
Lupus symptoms depend on what body organs are affected and how seriously they are affected.
Fatigue: About 90% of people with lupus have mild to extreme fatigue.4 Even mild cases of lupus cause an inability to engage in daily activities and exercise.5 Increased fatigue is a classic sign that a symptom flare is about to occur.
Joint and muscle pain: About 95% of people with lupus have joint pain (arthritis) at some time. About 70% of people with lupus report that joint and muscle pain was their first sign of the disease.4 Joints may be red and warm, and may swell. Morning stiffness may also be felt. Lupus arthritis often occurs on both sides of the body at the same time, particularly in the wrists, small joints of the hands, elbows, knees, and ankles.6
Skin problems: Most people with lupus develop skin rashes.6 These rashes are often an important clue to the diagnosis. In addition to the butterfly rash over the cheeks and bridge of the nose, other common skin symptoms include skin sores or flaky red spots on the arms, hands, face, neck, or back; mouth or lip sores; and a scaly, red, or purple raised rash on the face, neck, scalp, ears, arms, and chest.
Sensitivity to light: Exposure to ultraviolet light (such as sunlight or tanning parlors) typically worsens the skin rash and can trigger lupus flares. Sensitivity to light affects more than 50% of those with lupus, with fair-skinned people with lupus tending to be more sensitive.4
Nervous system symptoms: The majority of people with lupus develop nervous system problems, most commonly headaches, depression, or anxiety. Memory loss is less common.
Heart problems: People with lupus may develop inflammation of the heart sac (pericarditis), which may cause severe, sudden pain in the center of the left side of the chest that may spread to the neck, back, shoulders, or arms.
Mental health problems: People with lupus may develop problems such as anxiety and depression. Such problems can be caused by lupus, the medications used to treat it, or the stress of coping with chronic illness.
Fever: About 80% of people with lupus will sometimes have a low-grade fever related to the disease. Over a third of people with lupus report that fever was a first sign of the disease.4
Changes in weight: About 60% of people with lupus lose weight when their disease is active (flaring).4
Hair loss: Up to 50% of people with lupus experience periods of hair loss, either in patches or spread evenly over the head. This hair loss is usually not permanent.6
Swollen glands: Up to 50% of people with lupus eventually develop swollen lymph glands during a flare.4
Raynaud's phenomenon: This condition is present in about 20% of people with lupus.7 It affects the small vessels that supply blood to the skin and the soft tissues under the skin of the fingers and toes, causing them to turn white and/or blue or red. The skin affected will feel numb, tingly, and cold to the touch.
Inflammation of blood vessels in the skin (cutaneous vasculitis): Inflammation or bleeding from the blood vessels can lead to small or large blue spots or small reddish spots on the skin or nail beds.
There are other conditions with symptoms similar to lupus.
Vasculitis
Vasculitis is inflammation of the blood vessels. This inflammation can damage and narrow the blood vessels, causing a rash, a change in sensation, fatigue, or other symptoms.
Vasculitis has many possible causes, including allergic reactions and certain diseases, such as lupus.
Bleeding from the blood vessel may cause bruises or blood spots under the skin. Vasculitis can decrease blood supply to tissues or organs, causing blood clots, pain, tissue damage, and organ malfunction.
Treatment depends on the cause of the vasculitis. Some cases may be self-correcting. Treatment often includes anti-inflammatory medication, such as corticosteroids.
