Lupus and scleroderma have some similarities. They are both inflammatory autoimmune diseases that can affect multiple organs. In some cases, they can occur at the same time. However, lupus and scleroderma are distinct conditions.

Lupus can cause fever, tiredness, and sunlight-triggered rashes. In contrast, systemic scleroderma causes hardened skin patches.

Keep reading to learn about the similarities, differences, and relationship between lupus and scleroderma, including their symptoms, treatments, and prognosis for people with both conditions.

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Scleroderma and lupus have similarities, but they are distinct conditions.

Both conditions occur due to autoimmunity, which is when the immune system attacks the body’s healthy tissues. Both conditions also cause inflammation and can affect multiple parts of the body.

Scleroderma is primarily a skin disease, but when it affects other systems in the body, doctors call it systemic scleroderma, or systemic sclerosis. This form of the disease overlaps with lupus in terms of symptoms.

According to research from 2018, these conditions may develop in similar ways, too. Both cause strong platelet activation, which likely underlies how they develop and produce symptoms.

Platelets are a blood cell that enables clotting. Activation of platelets promotes dysfunction of the immune system and plays a prominent role in connective tissue thickening.

Yes, a person can have lupus and scleroderma, or systemic sclerosis, at the same time.

A disorder known as “overlap syndrome” can cause people to have two distinct conditions with overlapping symptoms simultaneously. They may manifest at the same time, or one may follow the other.

Research from 2018 involving 1,166 people with systemic scleroderma and 86 individuals with lupus showed that the prevalence of co-occurrence was 6.8%.

Below are the symptoms of each condition.


Lupus can affect one or many parts of the body, such as the skin, blood cells, kidneys, joints, brain, and lining of the heart. The symptoms may come and go or worsen over time. They include:

  • tiredness
  • fevers
  • painful, swollen joints
  • hair loss
  • facial rash across the nose and cheeks
  • scaly rashes on other parts of the body
  • sensitivity to the sun, which may cause a rash
  • Raynaud’s phenomenon
  • swollen glands
  • abdominal pain
  • sores in the mouth and nose
  • dizziness, headache, confusion, depression, or seizures
  • pain when lying down or breathing deeply

Systemic scleroderma

In scleroderma, the immune system attacks the skin, which causes inflammation and the production of excessive amounts of collagen. This leads to the development of hard, tight patches.

Localized scleroderma affects the skin and underlying tissues. The patches may develop in one of two patterns. One pattern consists of oval-shaped patches, which may have a yellow appearance with a reddish edge. The other pattern consists of lines of discolored or thickened skin, which run down a leg, arm, or, rarely, the forehead.

Systemic scleroderma can affect the blood vessels, tissues, heart, lungs, kidneys, and digestive organs, as well as the skin. The symptoms may include:

  • Raynaud’s phenomenon
  • tight, thickened skin around the fingers (sclerodactyly)
  • dysfunction of the esophagus
  • swelling of very small blood vessels, which causes red spots on the hands and face (v)
  • damage to organs

As lupus and systemic scleroderma have overlapping features, distinguishing between them can be challenging.

A doctor will ask about a person’s symptoms and take a detailed medical history. They will also perform a physical examination of the skin and any other visible symptoms.

To determine if the condition is lupus or scleroderma, or if it could be both, a doctor may recommend a number of tests. These could include:

  • blood tests for inflammation, certain antibodies, or blood clotting
  • medical imaging, to see any tissue or organ damage
  • lung function and upper gastrointestinal tests, to determine whether scleroderma is affecting these areas
  • tissue biopsy, which involves taking a small sample of tissue and sending it to a laboratory for testing

The presence of anti-topoisomerase I, which is a specific type of antinuclear antibody, may indicate scleroderma. Positive tests for other types of antibodies may indicate lupus.

People with both lupus and scleroderma tend to be younger in age than people with just one condition. According to a 2018 study, the average age of people in this group is 37.9 years. They may also be more likely to have pulmonary arterial hypertension and fewer skin manifestations.

Neither lupus nor scleroderma has a cure, but treatment can help control symptoms and protect organs from damage.

Those with scleroderma who only have a few hardened patches of skin may respond well to:

  • moisturizers
  • calcipotriene, a derivative of vitamin D
  • topical corticosteroids
  • imiquimod, which modifies the immune system response
  • tacrolimus ointment, a topical immunosuppressant
  • anti-itch products, such as camphor

Light therapy may also be an option. However, this may not be an option for people with lupus too, as UV light is a potential trigger for lupus symptoms.

People with more systemic scleroderma, or lupus, may need oral medications to control the symptoms. These could include:

A new treatment that scientists are testing for autoimmune diseases is extracorporeal photopheresis (ECP). This involves taking white blood cells out of a person’s blood using a machine, treating them with a drug that makes them sensitive to UV light, and then exposing them to UV. This destroys diseased cells.

Doctors can use ECP for severe scleroderma, but no studies exist yet on its ability to treat lupus.

The outlook for those with lupus and scleroderma depends on various factors, particularly the extent and severity of organ damage and complications.

Survival rates for lupus are 85–90% during the first 10 years. For systemic scleroderma, the 5-year survival rates are up to 80%. However, if pulmonary arterial hypertension is present, the 2-year survival rate is less than 50%.

Early, evidence-based treatments can slow the progression of these conditions and improve quality of life. If a person is concerned about their symptoms, they should seek medical advice as soon as they can, as the process of diagnosing lupus or scleroderma can take time.

Lupus and scleroderma are both autoimmune diseases that can cause many symptoms and affect multiple organs. Sometimes they can overlap or occur at the same time. However, they are distinct conditions.

Doctors determine whether a person has lupus, scleroderma, or both by taking a person’s medical history and running tests, such as antibody tests, medical imaging, and sometimes, tissue biopsies. Treatment for both conditions aims to reduce inflammation, a person’s symptoms, and damage to tissues and organs.

The outlook for those with either or both conditions depends on the severity of symptoms and any complications. Anyone with symptoms that could be lupus or scleroderma should talk with a doctor.