Lupus, short for systemic lupus erythematosus (SLE), is one of the more common autoimmune diseases (rheumatic diseases) and presents in a variety of ways with myriad symptoms such as rash, joint pain and fever.

"Lupus can affect many organ systems and can show up in different ways, which is why it is sometimes referred to as the disease with a thousand faces," says Professor Julian Thumboo, Senior Consultant from the Department of Rheumatology and Immunology at Singapore General Hospital (SGH), a member of the SingHealth Group.

Risk factors for lupus

Gender and ethnicity are risk factors for lupus. The disease can strike at any age, though it most often appears between the ages of 20 and 40.

"Women, particularly those of childbearing age, are more prone to this disease because of hormonal influences related to the female hormone oestrogen," explains Prof Thumboo.

Studies have shown that Asians such as Indians and Chinese are twice as likely to suffer from lupus as compared to Caucasians. Lupus also has more severe clinical manifestations in Asians than in Caucasians.

Besides gender and genetic factors, lupus can be caused by environmental factors such as certain viruses and exposure to the mineral silica. Since the female hormone oestrogen has a link to this chronic disease, HRT or hormone replacement therapy presents a small risk for lupus.

Previously, it was believed that the use of hair dye could be linked to lupus, but Prof Thumboo says that this association has now been ruled out. "Hair dye doesn’t trigger lupus," he says emphatically.

Symptoms of lupus

No two cases of lupus are exactly alike. However, the most common symptoms are a rash, typically a "butterfly" rash over the cheeks and bridge of the nose; joint pain, mostly affecting the fingers, hands and, wrists; and fever. 

Signs and symptoms may come on suddenly or develop slowly, may be mild or severe and may be temporary or last for a long period of time. Most people with lupus experience episodes – called flares – of worsening signs and symptoms that eventually improve or even disappear completely for a time with treatment. 

The course of the disorder is unpredictable, hence long-term treatment and follow-up is essential. The signs and symptoms of lupus will depend on which body systems are affected by the disorder. In general, they include:

  • Fever, fatigue and weight loss

  • Joint pain, stiffness, swelling and diffuse muscle aches

  • Butterfly-shaped rash on the face that covers the cheeks and bridge of the nose and worsens with sun-exposure 

  • Hair loss, mouth ulcers and easy bruising

  • Chest pain on breathing and shortness of breath

  • Swelling around the eye-lids, swelling of the feet and legs and decrease in urine output

  • When lupus affects the nervous system, patients can present with headache, memory or behavioural changes, drowsiness, stroke, muscle weakness, paralysis or fits

How to prevent lupus flare-ups

Certain lifestyle changes can reduce the likelihood of a lupus flare-up and improve overall wellbeing such as:

  • Get adequate rest and sleep

  • Be sun-smart, avoid sun-bathing and staying out of the sun entirely when it is the strongest i.e. 8am – 6pm.

  • Use sunblock and wear protective clothing

  • Get regular exercise but do not overstrain your body

  • Maintain a healthy, balanced diet

  • Do not smoke and avoid excessive alcohol intake

Types of lupus

There are 4 types of lupus, namely:

  1. Systemic Lupus Erythematosus (SLE): The generalised and most common form

  2. Discoid Lupus Erythematosus: Only affecting the skin

  3. Drug-induced Lupus: Lupus caused by drugs

  4. Neonatal Lupus: Lupus in babies born to mothers with SLE

The outlook for people with lupus was once grim, but diagnosis and treatment of the disorder has improved tremendously in recent years. 

With early diagnosis and treatment, most people with lupus can lead active lives.

Watch this video on lupus (systemic lupus erythematosus) to learn more!


Lupus is an automimmune disease

Under normal circumstances, the body’s immune system protects the body against “foreign” invaders like viruses, bacteria and parasites. For an autoimmune disease, the body’s immune system attacks its own tissues and organs instead.

In lupus (systemic lupus erythematosus), the immune system malfunctions and produces antibodies and cells which attack its own organs – hence lupus is known as an autoimmune disease. 

The reason why this happens is not known but lupus flares are commonly triggered by a combination of factors such as exposure to sunlight, stress or infection. There is also a genetic link since lupus occasionally runs in families.

Inflammation caused by lupus can affect many different body systems, including the joints, skin, kidneys, blood cells, brain, heart, lungs and intestines.

Lupus is just one of several autoimmune diseases. Find out what the rest are in this video. 


Read the next page to learn more about sun exposure and lupus (systemic lupus erythematosus) flare-ups.

Ref: H24 (ed)

Check out other articles on autoimmune diseases:

What are Autoimmune Diseases (Rheumatic Diseases)?

Rheumatoid Arthritis: What you Need to Know

Spondyloarthritis: An Inflammatory Rheumatic Disease

Osteoarthritis: Pain and Inflammation of the Joints

Autoimmune Disorders: Frequently Asked Questions