How to Identify & Treat a Lupus Rash on the Legs

Lupus is a group of autoimmune diseases that can affect multiple systems in the body, including the skin. Several rashes are linked to lupus, including some that itch and may appear on the legs.

This article discusses the types and causes of itchy lupus rashes on the legs, treatment options, and when to see a healthcare provider.

Itchy legs

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Types of Lupus Rash

Lupus can cause several types of rashes, including some specific to certain disease forms. Three common types of lupus are defined by cutaneous (skin) involvement. The four main lupus types are:

  • Systemic lupus erythematosus (SLE): May lead to symptoms in one or more of your bodily systems, including the skin
  • Acute cutaneous lupus (ACL): Usually appears alongside SLE
  • Chronic cutaneous lupus (CCL): Persistent skin involvement and can appear alongside SLE
  • Subacute cutaneous lupus (SCL): Can appear alongside SLE

If you have SLE, you may be prone to lupus-associated skin problems.

Acute Cutaneous Lupus

One of the most common skin symptoms of lupus is a malar rash. It’s referred to as a butterfly rash when it’s across the cheeks and nose. 

Malar rash is a type of ACL that is commonly seen in SLE. About 50% of people with lupus will develop a malar rash. While most commonly associated with lupus, a malar rash can be seen in other disorders, such as cellulitis, rosacea, and erysipelas.

Identifying Malar Rash
Itchy Sometimes
Leg involvement  Rarely 
Other locations  Face 
Color (on light skin)  Pink or red 
Color (on dark skin)  Red, brown, or darker patches 
Shape  Butterfly or coin-shaped patches
Raised or flat  Either
Scaly  Sometimes
Sun sensitive  Sometimes
Scarring  No 
Other features May feel hot

Chronic Cutaneous Lupus

CCL involves long-term skin inflammation. The most common type is called discoid lupus. In some people, CCL may be an early sign of SLE. Otherwise, symptoms are purely skin-based.

Identifying Chronic Cutaneous (Discoid) Lupus
Itchy Uncommon
Leg involvement  Uncommon
Other locations  Scalp, face, ears, neck, hands
Color (on light skin)  Pink with a red ring
Color (on dark skin)  Darker than the skin tone 
Shape  Disklike 
Raised or flat  Raised 
Scaly  Yes 
Sun sensitive  Yes 
Scarring  Common 
Other features Scarring may lead to loss of pigment (especially in dark skin), permanent hair loss

Subacute Cutaneous Lupus

SCL involves two types of sores (lesions): papulosquamous lesions and annular lesions. You can have one or both of them at different times or concurrently.

Identifying Papulosquamous Lesions
Itchy Uncommon
Leg involvement  Sometimes 
Other locations  Shoulders, back, chest 
Color (on light skin)  Red 
Color (on dark skin)  Red or darker than the skin tone 
Shape  Pimple-like 
Raised or flat  Raised 
Scaly  Yes 
Sun sensitive  Yes 
Scarring  Rarely 
Other features Small dots grow to cover large patches; often mistaken for psoriasis
Identifying Annular Lesions
Itchy Uncommon
Leg involvement  Sometimes 
Other locations  Anywhere with sun exposure 
Color (on light skin)  Red or pink, sometimes with a darker ring 
Color (on dark skin)  Red, skin-colored, or darker than the skin tone, sometimes with a lighter ring
Shape  Circular
Raised or flat  Raised 
Scaly  Yes, on the edges 
Sun sensitive  Yes 
Scarring  Rarely 
Other features Vary widely in size; often mistaken for psoriasis

Other Symptoms of Lupus

Other symptoms of systemic lupus vary somewhat by type. General lupus symptoms include:

  • Fatigue despite adequate sleep
  • Joint, muscle, and tendon pain and inflammation
  • Puffiness in the hands and feet and around the eyes
  • Recurring low-grade fever
  • Hair loss
  • Anemia
  • Dry eyes and mouth
  • Digestive problems
  • Raynaud's disease (causes fingers and toes to be cold and numb)

Many other symptoms are possible, depending on what organs or systems the disease targets.

Lupus and Hives

Lupus, especially SLE, sometimes causes hives. Hives are typically red, raised, and itchy. They can be anywhere on the body. The reason for hives in lupus isn’t fully understood, but some research suggests both may be autoimmune conditions.

Lupus Rash Treatment

Lupus rash treatments generally involve topical treatment (applied to the skin), oral medication (taken by mouth), and avoiding ultraviolet (UV) light.

Topical Treatment

Topical treatment includes corticosteroid creams. These are powerful anti-inflammatory medications. The strength that’s usually needed is only available with a prescription and should be used under the supervision of a healthcare provider.

Other topical anti-inflammatory medications may be used to avoid the possible side effects of corticosteroids.

Oral Medication

The medications for lupus-related skin problems may also be prescribed for the full range of lupus symptoms. They include:

Avoiding UV Light

Many lupus-related skin problems are exacerbated by sunlight. Avoiding UV light may involve staying out of direct sunlight, wearing strong sunscreen, such as with a sun protection factor of 50 (SPF 50), when outside, and wearing protective clothing. Take special care to keep out of the sun when you have an active rash.

When to See a Healthcare Provider

Anytime you have an unexplained rash, you should see a healthcare provider. Get immediate help if it is:

  • Especially itchy or painful
  • Covering much of your body
  • Spreading quickly
  • Blistering
  • Shows any signs of infection (swelling, crusting, pain, heat, red streaks, yellow or green pus)

If you’re diagnosed with lupus and notice any possible new skin involvement, let your rheumatologist or dermatologist know right away.


Lupus can cause a variety of rashes, some of which can affect the legs and be itchy. A malar rash is typical of SLE and acute cutaneous lupus. Chronic cutaneous lupus often causes a discoid rash. Subacute cutaneous lupus can cause two types of rash, one of which can be mistaken for psoriasis. Treating lupus rashes involves topical creams, medications, and avoiding sunlight. Contact your healthcare provider if you have a new, undiagnosed, or worsening rash.

A Word From Verywell

An itchy lupus rash, especially on large areas of your body, such as the legs, can be uncomfortable and can significantly impact your quality of life. Fortunately, there are treatment options that can make lupus-related skin problems manageable.

Frequently Asked Questions

  • What can help alleviate itchiness from a lupus rash?

    The primary treatment for an itchy lupus rash is corticosteroid cream, a potent anti-inflammatory drug. You’ll likely need a prescription-strength cream for it to be effective.

  • How long do lupus rashes last?

    How long lupus rashes last varies greatly. Some may go away after a few days or weeks. Others may last longer or even cause permanent damage.

  • What does subcutaneous lupus look like?

    Subacute cutaneous lupus causes rashes that are raised, scaly, and get worse when exposed to the sun. It may start out looking like pimples that eventually spread, or it may consist of discolored rings.

6 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
  1. Johns Hopkins Lupus Center. Lupus-specific skin disease and skin problems.

  2. Lupus Foundation of America. Lupus symptoms.

  3. Maurer M, Altrichter S, Schmetzer O, Scheffel J, Church MK, Metz M. Immunoglobulin e-mediated autoimmunity. Front Immunol. 2018;9:689. doi:10.3389/fimmu.2018.00689

  4. Lupus UK. Coping with itchy rashes.

  5. American Academy of Dermatology Association. Lupus and your skin: Diagnosis and treatment.

  6. American Academy of Dermatology Association. Rash 101 in adults: When to seek medical treatment.

Additional Reading

By Adrienne Dellwo
Adrienne Dellwo is an experienced journalist who was diagnosed with fibromyalgia and has written extensively on the topic.