What Is Acute Cutaneous Lupus?

Definition of Acute Cutaneous Lupus

Sun exposure can cause lupus lesions.
Sun exposure can cause lupus lesions. Sharon E. Lowe/Getty Images

People with lupus know the disease can affect various parts of their body, both inside and out, in a variety of ways. But one of the clearest signs that a person has developed the disease is the way it affects the skin (cutaneous disease).

There are, generally speaking, three types of lupus skin disease: chronic cutaneous (discoid lupus), subacute cutaneous, and acute cutaneous. Some people with discoid lupus may never develop the systemic version of the disease (systemic lupus erythematosus).

And those with subacute cutaneous lupus may develop arthritis, for example, while those with acute cutaneous lupus typically are people with active SLE.

Lesions associated with acute cutaneous lupus appear as flattened areas of red skin on the face, reminiscent of a sunburn – the tell-tale butterfly rash. These lesions can appear on the arms, legs, and body, and are photosensitive. Though these lesions may discolor the skin, they do not scar. Those with active SLE – those having a flare – often display these lesions.

Lesions typically appear during a flare or after sun exposure. People with acute cutaneous lupus should be aware of the dangers of prolonged exposure to sunlight. Sunscreens with SPFs above 30 that protect against both UVA and UVB rays should be applied every two hours. Consider appropriate clothing that can protect against the sun, as well. If sunscreen and topical agents don't work to relieve the skin symptoms of cutaneous lupus, systemic or oral medications are given.

Of note, acute cutaneous lupus has a high prevalence of conjunctive periodontal lesions, or lesions that are found on the gums, and mouth lesions are present in 45 percent of people with acute cutaneous lupus.

Acute cutaneous lupus is often treated with drugs such as prednisone, or in combination with other immunosuppressants.

Cutaneous Lupus Erythematosus: The Big Picture

Looking at the bigger picture, some people have only skin manifestations of lupus, and thus are diagnosed with cutaneous lupus erythematosus alone, which can be considered a separate type of lupus. However, cutaneous lupus lesions can also accompany systemic lupus erythematosus (SLE).

Ultimately, because of the wide range of symptoms, it can be challenging for the clinician to diagnose lupus, and most people are first diagnosed 5 years after first developing symptoms. Thus, if you feel that you may be experiencing symptoms consistent with a diagnosis of lupus, it's imperative that you visit with your physician and express this concern.

While examining a patient who is suspected of having either cutaneous lupus erythematosus alone or in combination with systemic lupus erythematosus, several factors are considered including the following:

  • physical exam findings
  • laboratory findings
  • antibody serology
  • histology
  • direct immunofluorescence


Lupus and the Skin. American Academy of Dermatology. December 2006.

Symptoms The Lupus Foundation of America. June 2007.

Aggressive Periodontitis and Chronic Cutaneous Lupus. Lupus Foundation of America. A Case Study, By Christina Tietmann, D.M.D., Aachen, Germany, and Nabil F. Bissada, D.D.S., M.S.D., Professor and Chair, Department of Periodontics, Case Western Reserve University, School of Dental Medicine, Cleveland, OH. November 2008.