There are several major types of lupus.
Systemic lupus erythematosus (SLE). This is the form of the disease most people mean when they talk about lupus. Approximately 70% of lupus cases are systemic, meaning the disease can affect any part of the body. About 50% of people with SLE have a major organ affected, such as the heart, lungs, kidneys, and brain.
People with SLE can have the whole range of symptoms listed above. Flares, or periods of time when the disease is active and the symptoms most serious, alternate with periods of improvement or remission.
Discoid lupus. This form of lupus is limited to the skin and is identified by a rash on the face, neck, scalp, or elsewhere. The rash may last for days or years, may go away and then reappear. The raised areas of the rash may become thick and scaly and heal with scarring.
About 10% of people with discoid lupus are later diagnosed as having the systemic form of the lupus. In those cases, the discoid rash was probably just the first symptom of the systemic form.
Subacute cutaneous lupus. This form of lupus is limited to areas of the skin that are exposed to the sun. Small areas of the skin become raised, red and crusty. They are not permanent and do not cause scarring.
Drug-induced lupus. As the name implies, drug-induced lupus is induced or brought on by drugs, usually prescription drugs. Only a small percentage of people taking those medications develop drug-induced lupus.
Symptoms of drug-induced lupus include rash, fever, chest pain, and inflammation of the sac around the heart (pericarditis). Symptoms usually disappear over time once the medication is stopped.
Neonatal lupus. Neonatal lupus is a rare condition that can occur among babies born to mothers who have lupus and to those who have the autoantibodies anti-Ro/SSA or anti-La/SSB. Autoantibodies in the blood of a pregnant woman's blood can pass to the fetus.
After delivery, the baby may develop a rash and heart, blood, and liver problems. These symptoms usually go away over the next several months. Occasionally, neonatal lupus can cause a serious heart problem that slows down the natural rhythm of the heart.
All pregnant women who know they have the autoantibodies anti-Ro/SSA or anti-La/SSB should have their hearts and surrounding blood vessels monitored as part of their prenatal care. Physicians can now identify mothers at highest risk for complications and offer prompt treatment.
Childhood onset lupus. While diagnosed earlier in the course of a person's life, childhood onset lupus may actually be diagnosed later in the course of disease than other forms of lupus. The diagnosis may be missed or delayed because many lupus symptoms mimic those of other childhood illnesses or may be seen as part of growing up. Delayed diagnosis increases the likelihood that the disease will be more active and involve internal organs, including the kidneys and the central nervous system. It may also mean that children with lupus may need intensive treatment soon after diagnosis. This is especially true if there is kidney damage.
Heart disease related to artherosclerosis, hardening of the arteries, is one of the more serious problems associated with childhood onset lupus. Young adults with lupus have an increased rate of heart attacks and strokes.
Early diagnosis and good disease control help prevent much of the organ damage in childhood onset lupus. Having symptoms evaluated by a physician knowledgeable about lupus can improve overall outcomes.
Childhood onset lupus is usually diagnosed between the ages of seven and puberty. Lupus rarely develops in children under five years old.
Childhood onset lupus is not fundamentally different from other forms of lupus, but children with lupus are more likely to have serious conditions. Children are still growing and developing and lupus, and the methods used to treat it can affect growth and development.
Late onset lupus. The estimated age for late onset lupus is 59 years old and the average age at diagnosis is 62. Diagnosis may be delayed because symptoms, such as achy joints and fatigue, may be difficult to distinguish from other conditions of aging. In addition, older people are more likely to have conditions such as high blood pressure and heart disease that require medications that cause the symptoms of lupus (drug-induced lupus).
Late onset lupus affects a higher percentage of men than lupus diagnosed at earlier ages, although women are more likely than men to have any form of lupus.
