Types of Cutaneous Lupus

NYU Langone dermatologists can identify the three main types of cutaneous lupus, a chronic skin condition in which rashes or sores typically appear on sun-exposed areas of the body, such as the face, scalp, chest, arms, and legs.

Cutaneous lupus is sometimes diagnosed in people who have systemic lupus erythematosus, an autoimmune disorder that affects joints and organs throughout the body. However, people can develop cutaneous lupus without ever being diagnosed with systemic lupus. 

Like systemic lupus, cutaneous lupus is caused by an autoimmune response, meaning the body attacks its own tissues and organs. In cutaneous lupus, the immune system targets skin cells, causing inflammation that leads to red, thick, and often scaly rashes and sores that may burn or itch.

Symptoms may flare up and disappear in unpredictable patterns. Without treatment, flares may persist for months or longer. Exposure to sunlight often triggers rashes and sores and exacerbates breakouts.

Cutaneous lupus may affect people of any age or gender, but it’s most common among women 20 to 50 years old.

The condition is not contagious, and it is generally not life threatening. However, dermatologists at NYU Langone understand that visible rashes and sores may affect how you feel about your appearance and can help you manage symptoms for the long term.

There are three main types of cutaneous lupus: acute, subacute, and chronic. A person may simultaneously have more than one type.

Acute Cutaneous Lupus

Acute cutaneous lupus is often a sign of systemic lupus erythematosus, a condition in which inflammation occurs throughout the body. The rash associated with acute cutaneous lupus appears in a recognizable butterfly pattern that spreads across the nose and cheeks. This rash is flat, red, and itchy, and it usually appears after sun exposure. Occasionally, a rash may appear on other parts of the body, such as the arms and legs. 

The facial rash is often confused with other skin conditions, such as rosacea, a disorder that causes redness of the face, or psoriasis, which may lead to rashes and lesions anywhere on the body. 

Subacute Cutaneous Lupus

Subacute cutaneous lupus may be a sign of systemic lupus, but it can also develop on its own. Most of the time, lesions aren’t itchy or painful, and they rarely cause scarring after they heal. A person may develop lesions associated with subacute cutaneous lupus in addition to those associated with other types of cutaneous lupus.

Subacute cutaneous lupus causes two kinds of lesions. The first, called papulosquamous lesions, appear as red, scaly patches that resemble pimples but can quickly spread to cover large areas of skin. Lesions are triggered by exposure to the sun and typically appear on the shoulders, back, and chest.

The second type of lesions caused by subacute cutaneous lupus is annular lesions. These are flat pink circles that have a red exterior. These lesions vary widely in size and may appear anywhere on the body but rarely develop on the face. They, too, may be mistaken for other conditions such as psoriasis.

Chronic Cutaneous Lupus

There are several types of chronic cutaneous lupus, with discoid lupus being the most common. 

“Discoid” refers to the round shape of the sores or lesions that develop. These are thick, raised, scaly patches that are often pink and may flake or form a crust on the surface of the skin.

Lesions most often appear on the face, ears, scalp, neck, and hands. They are usually not itchy or painful, but they may cause dark spots or scars that remain on the skin after they heal. Scarring on the scalp may destroy hair follicles and result in permanent hair loss.