Symptoms
SLE symptoms may develop slowly over months or years, or they may appear suddenly. Symptoms tend to be worse during winter months, perhaps because prolonged exposure to sunlight in the summer causes a gradual build-up of factors that trigger symptoms months later.
Arthritic Pain
The most common symptom is joint pain, occurring in about 90% of patients with SLE. Characteristics of this symptom vary widely:
- It is often accompanied by swelling and redness.
- It can last from hours to months.
- It may be mild or severe.
- It can occur in one joint, move from one to another, or flare erratically.
- Pain often occurs in the morning and improves during the day, only to return later when the patient tires.
- The joints most affected are fingers, wrists, elbows, knees, and ankles. (Joints in the spine and neck are not affected.)
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Children may experience these symptoms as growing pains, and, in all patients, they may be the only symptoms for many years.
Fever
Fever occurs in 90% of patients with SLE and is usually caused by the inflammatory process of the disease, not by infection. It is low-grade except during an acute lupus crisis.
Skin Rashes
Three-quarters of patients with SLE have skin inflammation and skin lesions (ulcers, rashes, or other injured areas). About half of these lesions are photosensitive; that is, they are aggravated by ultraviolet (UV) radiation from sunlight, even from light coming through a window. (UV radiation may even trigger systemic flares in patients with SLE.)
A number of different skin conditions have been described in patients with SLE.
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