There may also be a rash. The rash may be associated with recent sun exposure and is usually located on the face or arms (Lahita 1998). .
Over half of the patients with systemic lupus develop a characteristic red, flat facial rash over the bridge of the nose. Because of its shape, it is frequently referred to as the "butterfly rash- of lupus. The rash is painless and does not itch. The facial rash, along with inflammation in other organs, can be precipitated or worsened by exposure to sunlight, a condition called photosensitivity. This photosensitivity can be accompanied by a worsening of inflammation throughout the body, called a "flare- of disease (Encarta Encyclopedia 2001).
Most systemic lupus patients will develop arthritis some time during the course of their illness. Arthritis in systemic lupus commonly involves swelling, pain, stiffness, and even deformity of the small joints of the hands, wrists, and feet. Sometimes, arthritis of systemic lupus can mimic that of rheumatoid arthritis (JAMA 2001). Although, there is a similarity, the difference is that in lupus, although there is destruction of soft tissue around the joints, the bones are not destroyed. Patients with rheumatoid arthritis have significant joint inflammation but also have bone erosions as well (Lahita 1998).
The difficult to detect symptoms appear later and generally the physicians have no clues to the presence of kidney or brain disease caused by lupus until the organs are severely affected. When lupus affects the heart and lungs, the disease can cause mild shortness of breath or heart irregularity without the patient or physician knowing the actual cause (MedicineNet 2000). Inflammation of the lining of the lungs and of the heart can cause sharp chest pain. Coughing, deep breathing, and certain changes in body posture aggravate the chest pain and the heart muscle itself can rarely become inflamed (Wallace 1995).