Skin lesions: polymorphous, with edematous erythema being the most common, earliest, and most prominent; sphenowing-shaped erythema on the cheeks and periungual/fingertip erythema/petechiae are characteristic; some rashes can appear like erythema multiforme , more common in cold seasons; rashes caused by necrotizing vasculitis often occur on the limbs; symptoms such as wheals, annular erythema, purpura, livedo reticularis, Raynaud's phenomenon, lupus hair, photosensitivity, telangiectasia, and DLE may still occur , pigmentation often occurs after the rash subsides

Mucosal damage: May occur; manifested as red patches of telangiectasia or diffuse flushing with punctate bleeding, erosion, and shallow ulcers; often recurring

Kidney: most commonly affected; manifests as nephritis and nephrotic syndrome; in severe cases, renal failure may occur (the main cause of early death in patients)

Heart: Pericarditis, myocarditis, verrucous endocarditis, valvular disease

Lungs: Pleurisy, lupus interstitial pneumonia

Psychological nervous system: indicates a serious condition; manifests as mental symptoms, meningitis, encephalitis, peripheral neuritis

Digestive system: poor appetite, nausea and vomiting, abdominal pain and diarrhea, abnormal liver function

Blood system: WBC↓, Lysol, PLT↓

Motor system: myositis, arthritis

Eyes: conjunctivitis, scleritis, fundus hemorrhage, papilledema

Obvious fatigue, weight loss, fever

Blood routine: whole blood cells↓

Urine routine: hematuria, proteinuria

Others: increased erythrocyte sedimentation rate, Ig↑, complement C3/C4↓; false positive syphilis serum test, RF positive

antinuclear antibodies (ANA)

Anti-dsDNA antibodies: 40~70% positive; labeled antibodies at high titers; parallel to SLE; related to kidney damage

Anti-Sm antibody: 30% positive; labeled antibody

Anti-U1-RNP antibody: 30~40% positive; related to Raynaud’s phenomenon

Anti-SS-A antibody: 35% positive; associated with the occurrence of neonatal lupus erythematosus, Sjögren's syndrome, and photosensitivity Anti-SS-B antibody: 15% positive; associated with the occurrence of neonatal lupus erythematosus, Sjögren's syndrome

Anticardiolipin antibody: 30~40% positive; associated with thrombocytopenia, spontaneous abortion/stillbirth, thrombosis, vasculitis and neurological disease

Lupus cells: 50~80% positive when the disease is active

Skin: hyperkeratosis with parakeratosis, enlarged hair follicle openings, keratin plugs, acanthus atrophy, liquefaction degeneration of basal cells, patches of lymphocytes and a small amount of plasma cells/histiocytes infiltration around blood vessels and skin appendages; lupus band test ( lupus band test (LBT) shows Ig/C3 deposition at the epidermal-dermal junction in the lesion area, and the positive rate of LBT in seemingly normal skin is also as high as 70%.

Visceral: fibrinoid degeneration of connective tissue with lymphocyte, plasma cell, histiocytic infiltration and necrotizing vasculitis

Patient education (relieving worries, avoiding excessive ultraviolet radiation), nutritional support, and infection prevention; it is best for female patients not to become pregnant or to do this six months after their condition has stabilized.

Antimalarial drugs, NSAIDs: suitable for patients with mild systemic symptoms and only skin lesions/joint pain. Glucocorticoids: the main therapeutic drugs; severe patients can receive high-dose pulse therapy.

Immunosuppressants: Suitable for those who have poor efficacy of glucocorticoids alone/have contraindications; patients with lupus nephritis can use mycophenolate mofetil (Xiaoxi) for maintenance treatment; lupus encephalopathy can be treated with MTX intrathecal injection

High-dose IVIg: suitable for patients with combined anemia, thrombocytopenia and unsatisfactory effects of glucocorticoids

Biological agents, Chinese herbal medicine

Plasma exchange, hemodialysis, stem cell transplantation

1. Manifestation: The occurrence is closely related to ultraviolet irradiation. It often occurs in exposed parts such as the cheeks, the back of the nose, the outer ears, the back of the hands, and the lips. When it is limited to the neck and above, it is called localized DLE, otherwise it is called disseminated DLE; Typical skin lesions are characterized by bulging edges, a disc-like concave center, and are covered with adhesive gray-white scales. When the scales are peeled off, it can be seen that there are spiny keratin plugs in the expanded hair follicle openings underneath; the center of old lesions gradually shrinks, telangiectasia, and Pigmentation/hypopigmentation; some may involve mucous membranes, mostly on the lips (gray-white erosion/shallow ulcers, surrounded by redness); generally no subjective symptoms or systemic symptoms; chronic disease course, good prognosis, 5% can be converted to SLE

2. Examination: The pathology is similar to SLE; there may be positive LBT at the epidermal-dermal junction of skin lesions, but negative LBT in normal skin.

1. Manifestation: It commonly occurs on the cheeks, nose, helix, upper chest, shoulders, upper arms, etc.; it initially appears as edematous erythema, and later develops into annular erythema type, papule and squamous type; the skin lesions last for several months and then subside. Leaves scars; has varying degrees of systemic symptoms (but low incidence of renal and central nervous system lesions), photosensitivity and Raynaud's phenomenon; papulosquamous type is more likely to develop into SLE

2. Examination: Anti-Ro/SSA and anti-La/SSB antibodies are positive (characteristic); pathologically, there is no obvious hyperkeratosis, hair follicle plugs, epidermal atrophy, basement membrane thickening, and slight lymphocyte infiltration in the dermis but at the epidermal-dermal interface. Liquefaction is more significant; 10~25% of normal skin LBT can also be positive