Lupus Types: Systemic, Skin, Drug-Induced, and Neonatal

When people talk about “lupus,” they usually mean systemic lupus erythematosus (SLE), the most common type. But there are several other types and subtypes, some of which can overlap.

Lupus is a chronic autoimmune condition in which your immune system mistakenly attacks your body’s cells, tissues, and organs. It can present in different ways, causing different symptoms in different people.

In this article, we’ll discuss the different types of lupus and their main symptoms.

Systemic lupus erythematosus

SLE is the most common type of lupus. This type of lupus primarily affects people assigned female at birth, with Black people being at the highest risk.

SLE can affect multiple organs and systems within your body. It can cause inflammation in your:

Symptoms of SLE vary from person to person. They can include:

Cutaneous lupus erythematosus

Cutaneous lupus erythematosus (CLE) specifically targets the skin. Doctors further divide CLE into four main subtypes:

Chronic cutaneous lupus erythematosus

Chronic CLE (CCLE) lasts a long time and can lead to permanent scarring. The most common type is discoid lupus erythematosus (DLE), accounting for about 4 in 5 cases.

DLE causes inflamed, coin-shaped lesions on the skin. These lesions can appear anywhere on your body, most commonly on the face, scalp, and ears. DLE doesn’t usually affect your internal organs, but it can in some people, making them feel sick.

DLE mainly affects people assigned female at birth in their 40s and 50s.

Other types of CCLE include:

Intermittent cutaneous lupus erythematosus

Intermittent CLE is more commonly known as tumid lupus erythematosus (TLE) or lupus timidus. Previously, scientists considered TLE to be another type of CCLE.

TLE is a rare type of lupus that can affect anyone. Unlike many other types of this condition, TLE usually develops on its own, without any previous history of lupus.

TLE can give you a smooth, pink to violet papule rash on the skin. These lesions usually appear suddenly and may not leave scars. TLE tends to appear on sun-exposed areas of your body.

Subacute cutaneous lupus erythematosus

Subacute cutaneous lupus erythematosus (SCLE) can develop in people with SLE. It usually causes red, scaly lesions on the parts of your body exposed to the sun, such as your:

These lesions typically don’t leave scars as they heal, but they can cause long-term discoloration.

In many people, SCLE can spread into the joints, causing pain and swelling.

Acute cutaneous lupus erythematosus

Acute CLE (ACLE) usually refers to temporary skin symptoms in people with SLE. The symptoms can be localized, like the hallmark malar (or butterfly) rash. They can also be more widespread, resembling measles across the face, neck, arms, and torso.

In rare cases, ACLE may cause widespread fluid-filled blisters called bullae. Doctors call this bullous SLE, and it’s more common in people of African ancestry.

Drug-induced lupus erythematosus

Drug-induced lupus erythematosus (DILE) occurs as a reaction to certain medications. Scientists have identified more than 100 medications that can trigger DILE, but some of the most common are:

Your genetics play a role in how susceptible you are to developing DILE after taking these medications.

Symptoms of DILE are similar to those of SLE but are usually milder. They typically resolve once you stop taking the medication.

Neonatal lupus erythematosus

Despite its name, neonatal lupus erythematosus (NLE) isn’t really a type of lupus. It’s a rare autoimmune condition that can develop in a fetus or a newborn if their birthing parent has special autoantibodies (antibodies that attack their own cells) that pass through the placenta.

It can develop in babies whose parents have lupus, but it also can affect babies whose parents don’t have this condition.

NLE can cause the following symptoms in a newborn:

Most of these symptoms, except heart block, usually disappear after a few months. Those with heart block may eventually need a pacemaker.

Lupus in children

Lupus in children (pediatric lupus) is less common than lupus in adults. As in adults, the most frequent type of lupus in children is SLE.

In children, lupus most commonly affects the skin, joints, and major internal organs. It can be more aggressive or severe in children than in adults.

It usually develops in children around the age of 12. Children who develop lupus after age 13 tend to have more typical lupus symptoms. Those who develop it earlier, especially before age 5, tend to have a more severe condition.

Frequently asked questions

Let’s review a few questions that people with different types of lupus frequently ask their doctors.

Which is the worst type of lupus?

There isn’t a singular “worst” type of lupus, as this condition affects different people in different ways.

SLE can affect multiple organs and can be particularly challenging to manage. But with proper treatment, many people with SLE live happy, fulfilling lives.

Which types of lupus are rare?

There are several rare forms of cutaneous lupus. However, drug-induced lupus and neonatal lupus are the least common of the primary types, according to the Lupus Foundation of America.

Which types of lupus affect the skin?

Cutaneous lupus affects the skin. This type includes several different subtypes.

Other types of lupus, including systemic and drug-induced lupus, may also affect the skin, but they don’t always. Still, most people with any type of lupus will experience skin symptoms at some point.

Takeaway

Knowing the different types of lupus can help you better understand your specific condition. If you think you may have lupus, it’s important to speak with a medical professional. They’ll help develop a personalized treatment plan that addresses your specific needs and symptoms.

With proper management, many people with different types of lupus can lead active and fulfilling lives.