What Does a Lupus Rash Look Like on Black Skin?

While lupus can affect anyone, it is more common in females than in males and there is a higher prevalence in Black Americans and people of Native American and Asian descent more than other populations in the United States. People with dark-pigmented skin who have lupus are prone to skin conditions that arise from the lupus.

Systemic lupus erythematosus (lupus) is a chronic autoimmune disease that can affect any part of the body. In lupus, the immune system, which normally protects the body from infection and disease, attacks healthy tissues and organs leading to widespread inflammation.

This inflammation causes a variety of symptoms and can lead to permanent damage. Lupus is unpredictable and can affect the skin, joints, heart, lungs, kidneys, blood, and brain.

Symptoms of lupus can come and go. People with lupus often go through periods of illness or flares and periods of remission in which symptoms lessen or disappear.  

This article will discuss lupus rash on dark skin, other lupus symptoms, when to see a healthcare provider, how lupus is diagnosed, and treatment options.

Lupus Rash on Black Skin

People with lupus often experience skin involvement. Rashes, lesions, plaques, and scarring are common in up to 70% of people with the disease.

Most people with lupus will experience a malar rash (a rash across the bridge of the nose and upper cheeks). Sun is a common trigger for this type of rash.

Other lupus skin rashes can be either chronic (long term) or short term. These include discoid lupus, which causes round disk-shaped sores on the face and scalp that can scar and change colors.

A scaly rash or ring-shaped sores may also form on the neck and arms. These rashes can be caused by the sun and may be short term.

People with dark skin are more prone to experiencing these lupus rashes. On Black skin, the rashes tend to appear more frequently on the scalp and ears. These rashes can cause scarring and discoloration.

Dyspigmentation (a darker or lighter color than normal) is a common symptom of lupus rashes on dark skin. This may be due to increased melanin (dark pigment) in the skin or to loss of skin color in the scars, which causes a higher contrast between the scarred skin and healthy skin.

People with dark skin are also more prone to experience hair loss with scarring and should talk to their healthcare provider about gentle hair care practices.

Other Lupus Symptoms

Since lupus can attack any part of the body, lupus symptoms are varied and include:

• Fatigue
• Fever
• Joint pain and arthritis
• Sun sensitivity that can cause a rash
• Hair loss
• Sores in the nose and mouth
• Swollen glands
• Pain when breathing deeply or lying down
• Heart problems
• Blood clots
• Difficulty breathing from pleurisy, an inflammation of the tissues of the lungs
• Kidney damage from lupus nephritis that can lead to kidney failure

When to See a Healthcare Provider

If you have been diagnosed with lupus and experience any new or worsening symptoms, such as a skin rash, it’s important to tell your healthcare provider so that they can adjust your treatment plan accordingly.

If you have not been diagnosed with lupus but experience the symptoms listed here, talk to your healthcare provider so they can determine whether lupus is the cause of the symptoms.

Other signs and symptoms with lupus that should be seen immediately by a healthcare provider include:

• Chest pain
• Shortness of breath
• Seizures
• Severe abdominal pain
• New or high fever
• Bruising or bleeding anywhere on the body that is in excess
• Mood changes, confusion
• Severe headache with fever and stiff neck

Lupus Diagnosis

There is no one specific test to diagnose lupus. Diagnosing lupus can be a lengthy process as lupus symptoms are often mistaken for symptoms of other diseases.

To diagnose lupus a healthcare provider will take a full medical history, complete a physical exam, and ask if there is a family history of lupus or other autoimmune diseases.

The healthcare provider may also conduct other tests such as:

• Blood and urine tests: Urine tests will check kidney function and blood tests will look for a positive antinuclear antibody (ANA). While most people with lupus test positive for ANA, not everyone who tests positive will have lupus, so more specific tests will likely be ordered to rule out other diagnoses.
• A skin or kidney biopsy: A small amount of tissue is removed to examine under a microscope and determine if a rash or kidney damage is caused by lupus.

Lupus Treatment

While there is no cure for lupus, there are treatments to prevent flares, reduce organ damage, and lessen symptoms.

Medications for lupus include:

• NSAIDs (nonsteroidal anti-inflammatory drugs) are used for pain and swelling in joints and muscles.
• Corticosteroids can help with pain and swelling and can be used for flares to quickly reduce symptoms.
• Antimalarial drugs such as Plaquenil (hydroxychloroquine) are a standard treatment option for lupus. They can help with pain, fatigue, and lung inflammation and help prevent flares and prolong life with lupus.
• Biologics such as Benlysta (belimumab) can help with symptoms.
• Immunosuppressants/chemotherapy. Drugs like Trexall (methotrexate) can be used for severe lupus that has affected the organs.

Summary

Lupus is a chronic autoimmune disease that can affect any part of the body. Skin rashes are a common symptom, especially in Black people. In people with black skin, these rashes can causes scarring and discoloration.

While the diagnosis of lupus can take time and there is no cure, treatments for the disease exist to minimize symptoms, prevent flares, and prolong life.

A Word From Verywell

Living with the unpredictability of lupus can be difficult. Learning to live with your symptoms may take time to adjust to. Experiencing skin rashes that cause scarring and discoloration may add to the stress of living with the disease.

Talking to your healthcare provider about your concerns can help ease some of this stress. Don’t be afraid to seek second opinions if you don’t feel your concerns are addressed. Finding someone who understands the full impact of scarring, discoloration, and hair loss can help you feel more at ease.