Lupus can affect the skin and cause rashes anywhere on the body. People may experience a lupus rash on the chest following exposure to sunlight.

Lupus is a long-term autoimmune condition. It occurs when the body’s immune system mistakenly attacks healthy tissues and organs. This results in inflammation that causes a wide range of symptoms, including fatigue, joint pain, and skin rashes.

Systemic lupus erythematosus (SLE) is the most common form of lupus. Evidence suggests that about 4 in 5 of those with SLE experience skin-related issues. These skin rashes may occur spontaneously or as a reaction to sun exposure.

In this article, we discuss what types of lupus may appear on the chest and how to manage lupus rash.

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Health experts may use the term cutaneous lupus to describe a form of lupus that affects the skin. There are four subtypes of cutaneous lupus. They include:

  • acute cutaneous lupus erythematosus (ACLE)
  • subacute cutaneous lupus erythematosus (SCLE)
  • intermittent lupus erythematosus (ICLE)
  • chronic cutaneous lupus erythematosus (CCLE)

Each of these rashes has its own characteristic presentation and tends to appear on different areas of the body. A person may show more than one type of rash.

SCLE is one type of lupus rash that commonly affects the chest. This type often spares the face, and most commonly affects sun-exposed areas like the following:

  • upper chest
  • upper back
  • arms
  • neck
  • shoulders

These lesions are not painful and do not itch or scar.

However, they may leave areas of lighter skin and spider veins on the skin, also known as telangiectasia. They are often mistaken for eczema or psoriasis.

SCLE causes two types of lesions. Papulosquamous lesions may appear as red, raised, scaly patches with distinct edges. While annular lesions are flat, ring-shaped circles that vary widely in size and may overlap.

ICLE, also known as lupus tumidus, is another form of lupus that may affect the chest. It typically occurs in areas that receive sun exposure and may resolve in winter without scarring. The lesions typically present as round papules and plaques with a smooth surface.

ACLE is another type of lupus rash. It usually occurs alongside an SLE flare. The butterfly or malar rash is the most commonly associated rash with acute cutaneous lupus. This flat, red, and itchy rash spreads across the cheeks and nose. But ACLE may also cause generalized rashes, leading to a widespread rash in a photosensitive pattern, which makes it possible to affect the chest.

In darker skin tones, it can cause hypo-pigmentation, or skin lightening, presenting as red, brown, or dark purple in these areas.

CCLE is the most common form of cutaneous lupus. These are different forms of CCLE, and while it can impact the chest, it most often appears on the scalp or face.

People with lupus can develop a rash anywhere on their body exposed to the sun. Ultraviolet (UV) light radiation can trigger and worsen these rashes.

In addition to the chest, other commonly exposed skin areas include:

  • face
  • lips
  • scalp
  • ears
  • hands
  • arms
  • thighs

However, people with cutaneous lupus can also get rashes on skin areas that get little to no sunlight, including:

  • breasts
  • buttocks
  • back

Because lupus is an autoimmune disease affecting almost all organs in the body, it can cause a wide range of symptoms. These can include:

  • muscle and joint pain
  • fever
  • extreme or prolonged fatigue
  • chest pain
  • hair loss
  • kidney problems
  • mouth sores or ulcers
  • anemia
  • eye issues like dry eyes or vision changes
  • memory problems
  • bleeding and clotting problems
  • gastrointestinal issues like nausea and vomiting

Learn more about lupus symptoms here.

At present, there is no permanent cure for cutaneous lupus, but lifestyle changes and medications can help manage skin rashes and lesions.

Lifestyle changes that protect the skin from UV light can help prevent and ease symptoms. These strategies can include:

  • timing activities appropriately to avoid sun exposure
  • wearing lightweight, loose-fitting dark clothing that covers skin
  • applying broad-spectrum UVA and UVB sunscreens with a sun protection factor (SPF) of 30 or higher

People sensitive to indoor lighting can also place light shields over fluorescent bulbs or bulbs that send out lower amounts of UV radiation. UV-blocking shades for windows can also help block sunlight from outside.

Depending on the severity of the person’s symptoms, doctors may prescribe topical or oral medications to treat lupus skin problems. A doctor may recommend any of the following medications:

  • Antimalarials: This is an effective option for most cutaneous manifestations. Doctors usually prescribe hydroxychloroquine.
  • Steroids: These drugs can help manage inflammation. They may come in the form of creams, pills, or injections. A doctor may also prescribe systemic steroids in people with severe or resistant disease.
  • Calcineurin inhibitors: These medications can address skin inflammation by blocking the calcineurin protein in the blood. Examples include tacrolimus ointment and pimecrolimus cream.
  • Immunomodulators: Doctors may also consider prescribing immunomodulators or immunosuppressives. These drugs suppress the immune system. These include drugs such as methotrexate and mycophenolate mofetil.
  • Anti-inflammatory medications: These medications, such as ibuprofen, help reduce joint pain and inflammation.

Below are some commonly asked questions about lupus.

What do lupus chest pains feel like?

Lupus can cause inflammation in the lining of the lungs. This feels painful when a person breathes deeply.

Does lupus make your chest hurt?

Yes, lupus can make a person’s chest hurt. Lupus triggers inflammation in the lining of the lungs, thus causing chest pain when a person breathes deeply.

How do you know if lupus is affecting your heart?

Lupus can increase a person’s risk for heart disease, including coronary artery disease(CAD).

It can also cause inflammation in different parts of the heart. Signs that lupus may be affecting a person’s heart include:

  • chest pain
  • swelling
  • fatigue with exertion
  • irregular heartbeat
  • shortness of breath
  • pain with a deep breath

Lupus is an autoimmune condition that can affect different body organs, including the skin.

Skin symptoms of lupus often appear in areas that receive sun exposure, such as the chest. However, lupus can also affect skin areas that do not receive sun exposure.

Currently, there is no cure for these skin lesions, but lifestyle changes and medications can help manage them.