Where does lupus erythematosus usually occur?

Generally, cutaneous manifestations of lupus erythematosus are diverse and can occur in various locations, mainly distributed on the face, scalp, neck, upper chest, limbs, and lips. If you experience any discomfort, please seek medical attention promptly and undergo symptomatic treatment under the guidance of a qualified physician. Detailed analysis is as follows:

1. Face

The malar rash, or butterfly rash, is one of the classic cutaneous manifestations of systemic lupus erythematosus (SLE), occurring in approximately half of patients. The rash typically appears on the bridge of the nose and both cheeks, presenting a butterfly-like appearance. The rash is usually symmetrically distributed, varying in color from light red to purplish red, with relatively well-defined borders. It results from inflammation around skin blood vessels and deposition of immune complexes, which may lead to skin damage and color changes.

2. Scalp

Patients may develop erythema and scaling on the scalp similar to seborrheic dermatitis; however, cutaneous lupus lesions of the scalp are often accompanied by hair loss. There are two forms of alopecia: one resembles alopecia areata, presenting as localized thinning or complete hair loss with irregular borders; the other is diffuse alopecia, where hair gradually becomes fine, brittle, and prone to breakage, leading to overall thinning. These lupus-related scalp lesions result from inflammatory reactions around hair follicles that damage the follicles, thus affecting normal hair growth.

3. Neck and Upper Chest

Erythematous rashes or papules may appear on these areas. The rash on the neck may follow the contour of the collar line, possibly related to frequent skin friction and exposure to sunlight. These factors may lead to more pronounced immune responses in these areas. Rashes on the upper chest may appear as isolated or confluent erythematous or purplish-red papules or macules. These lesions similarly result from immune responses and vascular inflammation in the skin.

4. Limbs

Erythematous lesions often appear around joints of the fingers, wrists, elbows, and knees. These rashes may be associated with joint inflammation, as joint involvement is common in systemic lupus erythematosus. Inflammation may spread to surrounding skin, causing erythema. Additionally, these perijoint rashes may sometimes be accompanied by pain and swelling, interacting with arthritis symptoms, leading to significant discomfort for patients.

5. Lips and Oral Mucosa

Lupus erythematosus patients may also develop mucosal erythema, erosion, or ulcers on the lips, causing discomfort and affecting eating and speaking.

In daily life, it is important to avoid direct sunlight exposure to the skin, maintain clean and dry skin conditions, and prevent infections.