Lupus erythematosus – symptoms

As with all collagen and autoimmune diseases, the spectrum of possible symptoms in systemic lupus erythematosus (SLE) is broad. This is because there is connective tissue throughout the body, so very different organs and locations can be affected by the inflammatory reactions and thus the lupus disease. In discoid lupus erythematosus, however, there are usually only changes to the skin.

SLE: symptoms of systemic lupus

The symptoms of SLE occur with varying frequency and severity. The symptoms of SLE, which used to be very pronounced in the past due to organ inflammation, have now become quite rare due to the therapy. The following symptoms are relatively typical of lupus disease, especially when several occur together:

• Hair loss (often the first sign of the disease)
• Skin changes, often as a butterfly erythema on the face (flat to slightly raised, bright reddening of the cheeks that runs down the bridge of the nose)
• General complaints (tiredness, poor performance, difficulty concentrating)
• Joint pain, joint inflammation (symptoms similar to rheumatism)
• Muscle aches
• dry eyes (due to reduced tear secretion)
• Hypersensitivity to light (photosensitivity) with signs such as headache, fatigue and fever after exposure to the sun
• Symptoms caused by inflammation of the following organs: gastrointestinal tract, kidneys, pleura, lymph nodes, pericardium and heart muscle, lungs, pancreas, brain

Symptoms of chronic discoid lupus (CDLE)

The symptoms in the form of changes to the skin are pretty typical of chronic discoid lupus (CDLE) and are divided into three areas:

• Areas about the size of a coin on the skin with firmly attached scales, under which there is a spur-like extension after detachment (“wallpaper nail phenomenon”)
• Reddened edge around the skin area
• In the middle is tissue wasting with skin scarring, characterized by lighter-pigmented dents and often permanent hair loss.

These CDLE symptoms on the skin occur intermittently and usually after sun exposure – especially where the skin is exposed to the sun, i.e. face, décolleté and neck. Small ulcers in the mouth and the back of the cheeks also occur as symptoms. Apart from these symptoms, those affected by this lupus disease feel otherwise healthy.

If the skin changes are extensive, susceptible to light, not dented and only slightly scaly, it is more likely to be subacute cutaneous lupus erythematosus (SCLE).