Does lupus cause itchy skin?

Written by Zhang Lin
Rheumatology and Immunology Nephrology
Updated on September 25, 2024
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The rash in patients with lupus erythematosus is generally not noticeably itchy. In patients with lupus erythematosus, the characteristic changes include a butterfly-shaped rash on the bridge of the nose and cheeks. The skin lesions of lupus erythematosus include photosensitivity, hair loss, erythema on the palms and soles and around the nails, discoid lupus, nodular erythematosus, seborrheic dermatitis, livedo reticularis, and Raynaud's phenomenon, among others. Generally, there is no noticeable itching. If significant itching occurs, it suggests an allergy. Itchy rash after immunosuppressive treatment should be monitored for fungal infections. Lupus patients receiving steroid and immunosuppressive therapy, if experiencing unexplained localized skin burning, may be showing early signs of herpes zoster and should seek prompt medical attention at a hospital.

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Written by Liu Li Ning
Rheumatology
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How long will the skin itch in the early stages of lupus erythematosus?

The duration of itching in the early stages of lupus erythematosus is not fixed. It is not certain that early-stage lupus erythematosus will cause itching. Some patients may experience itching, which can subside on its own, but it tends to recur. Additionally, some patients may have itching due to allergies, which can result in rashes accompanied by itching. It is possible to check immunoglobulin E to see if there are any allergic factors present. If allergies are involved, treatment can include antihistamines or corticosteroids, or topical calamine lotion can be used to relieve symptoms. Besides affecting the skin, early-stage lupus erythematosus can also cause symptoms such as oral ulcers and arthritis in many patients.

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Written by Liu Li Ning
Rheumatology
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What is lupus and is it serious?

Lupus erythematosus is an autoimmune disease, which can be very severe in some cases and mild in others. For example, cutaneous lupus erythematosus generally does not involve major organs and usually presents with mild symptoms, primarily affecting the skin and mucous membranes. However, systemic lupus erythematosus can affect significant organs like the kidneys and heart in many patients, often leading to severe medical conditions. Especially, patients with rapidly progressive glomerulonephritis and those with coronary atherosclerotic heart disease tend to have a higher mortality rate. If systemic lupus erythematosus is diagnosed, it is crucial to receive standardized treatment early. Typically, treatment involves long-term maintenance with corticosteroids and immunosuppressants to control the progression of the disease and reduce the likelihood of mortality.

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Written by Zhang Lin
Rheumatology and Immunology Nephrology
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What should I do if I have a fever with lupus erythematosus?

When patients with lupus experience fever, the fundamental approach is the use of ample steroids or other immunosuppressive drugs for treatment, which generally can quickly normalize body temperature. However, some patients may also experience fever during steroid use, possibly due to the steroids reducing immune function and inducing a bacterial infection. At this point, it is necessary to find evidence of infection and promptly treat with adequate sensitive antibiotics. Then, there will certainly be questions about why patients with lupus who have a fever cannot use antibacterial drugs or antipyretics. This is because fever in lupus patients is often an important indicator of disease activity. During acute phases, the fever is typically high, not caused by external infections, thus antibacterial drugs are ineffective. Using antipyretics can temporarily normalize body temperature, but once the effect of the medication wears off, the high fever may recur. Patients with lupus should not casually use medications. If medication is needed, it should be used under the guidance of a doctor.

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Written by Zhang Lin
Rheumatology and Immunology Nephrology
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Lupus is what disease?

Lupus erythematosus, also known as systemic lupus erythematosus, is a chronic autoimmune disease involving multiple systems and organs. Patients' serum contains various autoantibodies, with the main pathological changes being inflammatory reactions and vascular abnormalities. Most patients exhibit butterfly-shaped erythema on the bridge of the nose and cheeks, which is the most characteristic manifestation of lupus erythematosus. The clinical presentations of systemic lupus erythematosus are diverse, generally characterized by the "four multiples": involvement of multiple systems, multiple organs, multiple autoantibodies, and a higher prevalence among women of childbearing age. Without proper and effective treatment, the mortality rate is high, with the main causes of death being infections, renal failure, and damage to the central nervous system.

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Written by Liu Li Ning
Rheumatology
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What does the early rash of lupus look like?

The early characteristic rash of lupus erythematosus is typically a butterfly-shaped rash on the face. Other common presentations include palm and periungual erythema, discoid rash, nodular erythema, and livedo reticularis. If the rash is not notably itchy, it generally indicates lupus erythematosus. If there is significant itching, it may suggest the possibility of an allergic factor active in the disease. After immunosuppression, itchy rashes should be monitored for possible fungal infections. The specific pathogenesis of systemic lupus erythematosus is still unclear. If a patient exhibits the typical butterfly-shaped rash on the face, systemic lupus erythematosus should be highly suspected. Testing for antinuclear antibodies, and specifically for anti-Sm and double-stranded DNA antibodies, which represent a variety of autoantibodies, can diagnose systemic lupus erythematosus.