Lupus, a chronic autoimmune disorder that causes inflammation, creates a wide range of signs and symptoms.

The first signs of lupus can vary from person to person, and the variety of symptoms can make it tough to spot.

Some of its most common symptoms — such as fatigue, headaches, joint pain, swelling, and fever — occur with a lot of other illnesses too.

Lupus can imitate conditions like rheumatoid arthritis, blood disorders, and fibromyalgia.

So, what are the signs it might be lupus and not something else?

Symptoms of Lupus

Here’s what to know about the most common early signs of lupus, to help you better identify and learn about symptoms that might indicate the disease.

Cutaneous Rash

Estimates suggest that between 40 and 70 percent of people with lupus will notice that their symptoms get worse in the sun or in some types of artificial light.

One main type of lupus, cutaneous lupus erythematosus, is limited to skin symptoms, including a rash and lesions.

People with cutaneous lupus most commonly develop a discoid rash. It appears as round, raised, red patches, usually above the neck. Discoid rashes can cause scarring, but they usually aren’t itchy or uncomfortable.

Another subtype of cutaneous lupus is subacute cutaneous lupus, and people with it will develop thick, scaly, red lesions that usually don’t itch or scar.

Malar Rash (Butterfly Rash)

About 50 percent of people with systemic lupus erythematosus (SLE) experience a malar rash, also called a butterfly rash. It spreads across the bridge of the nose and cheeks and is a telltale sign of the disease because its appearance is so distinctive.

A malar rash can be flat or raised, and it can itch or burn, causing pain. It can also appear on other parts of the face.

Fatigue

Up to 90 percent of people with lupus experience fatigue. Fatigue may be brought on by the disease itself or from medication or associated physical or mental factors.

Fever

Unexplained fever (a temperature of more than 100 degrees Fahrenheit) is another common sign of lupus. Some lupus medications can increase the risk of infection, which can also bring on a fever.

Sore and Stiff Joints

Most people with lupus will experience joint inflammation at some point.

Inflammation associated with lupus can cause stiffness, swelling, pain, and warmth of the joints, most commonly in the:

Fingers
Hands
Wrists
Elbows
Ankles
Toes

Raynaud’s Syndrome

Raynaud’s syndrome is a condition in which the small blood vessels in the fingers and toes spasm, limiting circulation. It affects about one-third of people with lupus and can cause color loss in the fingers and toes, which first turn white or blue, followed by red with rewarming.

People with Raynaud’s are extremely sensitive to cold temperatures and, in those conditions, will often notice a loss of circulation and loss of color in their digits much more quickly than people without the condition.

Headaches

Some people with lupus may experience headaches caused by inflammation of the blood vessels in the brain, also known as vasculitis. It could also cause thrombosis, which is characterized by blood clots within these blood vessels.

Mouth or Nose Sores

People with SLE may experience mouth or nose sores. Let your doctor know about any sores you notice.

Hair Loss

The inflammation of the skin associated with lupus can sometimes result in hair loss. Once lupus is treated, the hair may grow back. But discoid rash may cause scarring on the scalp and permanent hair loss.

Some of the medications used to treat lupus may also cause the hair to fall out, though this is sometimes temporary.

Types of Lupus

There are four main types of lupus.

Systemic Lupus Erythematosus

Systemic lupus erythematosus, or SLE, is the most common form of lupus. It can potentially involve any major organ system of the body, especially the kidneys, skin, and joints.

Cutaneous Lupus

This form of lupus mainly affects the skin. There are several subtypes:

Acute cutaneous lupus
Chronic cutaneous lupus erythematosus (also known as discoid lupus erythematosus)
Subacute cutaneous lupus erythematosus

Drug-Induced Lupus

This form of lupus is distinct from SLE and can happen after taking certain prescription drugs, such as:

Antitumor necrosis factor drugs, which are prescribed for conditions like psoriatic arthritis and rheumatoid arthritis
Hydralazine, which is occasionally used for high blood pressure
Isoniazid, which is used for tuberculosis
Minocycline, which is prescribed to treat acne
Procainamide, which is occasionally used for irregular heart rhythms

Neonatal Lupus

Neonatal lupus is a rare form of lupus that affects babies of mothers with certain antibodies that affect the baby.

Potential Complications of Lupus

With early diagnosis and treatment, many of the symptoms of lupus can be managed. But a variety of complications can arise from lupus, causing an array of additional symptoms.

Some of these complications include the following conditions.

Lupus Nephritis

Lupus nephritis, inflammation of the kidneys, is one of the most common complications of lupus.

People with lupus nephritis are at a higher risk of developing kidney failure, requiring dialysis or a transplant.

Symptoms of lupus nephritis include:

High blood pressure
Swelling of the hands, ankles, feet, legs, or face
Changes in urination (blood or foam in urine, increased nighttime urination frequency, pain or trouble urinating)
High levels of creatinine in the blood

Blood Disorders

Lupus can cause problems with the blood, too, including anemia, or low red blood cell count. Anemia can cause symptoms such as dizziness and fatigue.

Thrombocytopenia is another blood disorder that may develop, resulting in lower platelet counts. Symptoms of thrombocytopenia can include bruising easily, nosebleeds, and petechiae (blood appearing as red pinpoints under the skin).

Atherosclerosis

Atherosclerosis, or clogging of the arteries, is the most common form of cardiovascular disease among people with lupus. It can lead to complications like stroke and heart attack.

Pericarditis

Pericarditis, or inflammation of the sac that surrounds the heart, can be an early complication of lupus. Symptoms include a sharp pain in the chest, shortness of breath, or pain with deep breaths.

Myocarditis

Inflammation of the heart, called myocarditis, can cause chest pain. Other symptoms include irregular heartbeat or fatigue with exertion.

Pleuritis and Pleural Effusion

Inflammation of the lining surrounding the lungs, or pleuritis, can occur in people with lupus. This can cause symptoms such as chest pain and shortness of breath. The pain can worsen when taking a deep breath, sneezing, coughing, or laughing.

Pleural effusion, or fluid around the heart and lungs, may also develop.

Central Nervous System Inflammation

Inflammation of the central nervous system can cause confusion, seizures, and psychosis. It can contribute to an increased risk of depression, headache, and stroke, as well as problems with vision in people with lupus.

Miscarriage and Preterm Labor

Women with lupus have a higher risk of miscarriage and preterm labor. Pregnant women with lupus also have a higher risk of preeclampsia — a serious condition causing increases in blood pressure and protein in the urine — and signs that the kidneys and liver may not be functioning well.

If you have lupus and do get pregnant (or if you have lupus and are trying to get pregnant), see a high-risk maternal-fetal medicine specialist who has expertise in how to best handle such pregnancies.

Be sure to talk with your rheumatologist well in advance of trying to get pregnant (at least three to six months before you start trying to get pregnant).

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Resources

Lupus Symptoms. Lupus Foundation of America. July 25, 2023.
Common Diseases That Overlap With Lupus. Lupus Foundation of America. October 30, 2024.
UV Exposure: What You Need to Know. Lupus Foundation of America. June 7, 2021.
Lupus-Specific Skin Disease and Skin Problems. Johns Hopkins Lupus Center.
Lupus Signs and Symptoms. Lupus Research Alliance.
Butterfly (Malar) Rash. Cleveland Clinic. March 30, 2025.
Medications Used to Treat Lupus. Lupus Foundation of America. July 25, 2023.
Lupus and the Joints, Muscles, and Bones. Lupus Foundation of America. July 27, 2021.
Vasculitis and Lupus. Lupus Foundation of America. April 14, 2023.
What Is Thrombosis? Lupus Foundation of America. August 8, 2013.
Lupus and Hair Loss. Lupus Foundation of America. August 26, 2021.
Types of Lupus. Johns Hopkins Medicine.
Justiz Vaillant AA, et al. Systemic Lupus Erythematosus. StatPearls. August 4, 2023.
Lupus Nephritis: Symptoms and Causes. Mayo Clinic. January 31, 2025.
Lupus Nephritis: Diagnosis and Treatment. Mayo Clinic. January 31, 2025.
What You Need to Know About Anemia. Lupus Foundation of America. April 13, 2023.
Lupus and Thrombocytopenia. Lupus Foundation of America. April 14, 2023.
How Does Lupus Affect the Cardiovascular System. Johns Hopkins Lupus Center.
Lupus and the Heart, Lungs, and Blood. Lupus Foundation of America. November 19, 2021.
How Lupus Affects the Lungs and Pulmonary System. Lupus Foundation of America.
Lupus and the Nervous System. Lupus Foundation of America. June 15, 2021.
Lupus and Pregnancy. Lupus Foundation of America. June 27, 2021.
Lupus: Symptoms and Causes. Mayo Clinic. October 21, 2022.

Samir Dalvi, MD

Medical Reviewer

Castle Connolly Top Doctor

Samir Dalvi, MD, is a board-certified rheumatologist. He has over 14 years of experience in caring for patients with rheumatologic diseases, including osteoarthritis, rheumatoid arthritis, psoriatic arthritis, ankylosing spondylitis, lupus, and gout.

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Heather Lindsey

Author

Heather Lindsey is a freelance health and medical writer who covers topics such as cancer, digestive disorders, heart disease, diabetes, obesity, arthritis, allergies, nutrition, fitness, pregnancy, pediatrics, aging, and complementary medicine. In addition to contributing to Everyday Health, she writes and edits patient and academic web content for NYU Langone Health, covers research news for Weill Cornell Medicine, and reports on healthcare trends for Business Insider. She has also blogged for UCLA Health Connect and Johns Hopkins Healthy Aging and Healthy Mind. Heather lives in the New York metropolitan area.

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