Lupus Erythematodes Differential Diagnosis Table

Lupus Erythematodes Differential Diagnosis Table:

Systemic lupus erythematosus, which is the most common form of lupus, is an autoimmune disease where the immune system attacks its own organs or tissues, leading to inflammation and damage of these organs or cells. Some of the organs that can be affected include the skin, brain, lungs, kidneys, and joints.

The main cause of lupus erythematosus is still anonymous, but many researches have linked its cause to the interaction between genetic, environmental, and hormonal factors. Some medications can also cause lupus. Treatment has also not been found for lupus, but different lifestyle modifications and environmental modifications, and some medications can control it to improve the quality of life of an individual.

Most of the symptoms of lupus are dependent on the organs they affect, but some of the common signs and symptoms include joint pain and swelling, fatigue, fever, hair loss, weight loss, mouth sores, sensitivity to sunlight, skin rash, swollen lymph nodes, and general body discomfort. Some people also end up developing arthritis.

How to Distinguish Lupus Erythematosus from Other Diseases

Distinguish Rosacea from Lupus Erythematosus – Diagnosis

This is an inflammatory condition on the skin, mainly seen in women, characterized by redness or a rash on the face or other parts of the body. Some of the possible symptoms on the skin can be small red bumps, bumps that contain pus, stinging, burning, and sensitivity.

• Rosacea majorly affects the skin while lupus erythematosus affects different parts of the body, including the skin but mainly the joints.
• Lupus erythematosus is an autoimmune condition while rosacea isn’t.
• Diagnosis of rosacea is primarily based on the symptoms with no specific laboratory investigations while the diagnosis of lupus erythematosus requires blood tests for antibodies.
• Rosacea mainly presents with facial redness while lupus erythematosus presents with a malar rash and coin-shaped red patches.

Distinguish Erysipelas from Lupus Erythematosus – Diagnosis

This is a bacterial skin infection, caused mainly by streptococci, characterized clinically by shiny, raised, indurated, and tender plaques. Symptoms are accompanied by high fever, chills, and malaise. It involves the upper dermis that characteristically extends to the superficial cutaneous lymphatics.

• Erysipelas is caused by bacteria, specifically group A beta-hemolytic streptococci, while lupus erythematosus is an autoimmune disease.
• Erysipelas mainly affects the skin while lupus erythematosus affects various parts of the body.
• Erysipelas skin manifestation is well-demarcated with a raised edge while lupus erythematosus presents with rashes.

Distinguish Psoriasis from Lupus Erythematosus – Diagnosis

This is a complex chronic autoimmune condition that involves the buildup of keratinocytes in the epidermis. Apart from immunological factors, environmental and genetic factors also play a role in development.

• Lupus erythematosus can affect different organs of the body, including the skin, joints, and internal organs, while psoriasis majorly affects the skin, though it might also affect the joint in certain circumstances.
• Psoriasis is characterized by the rapid buildup of skin cells leading to thick silvery and itchy patches, while lupus erythematosus presents with rashes on the skin.

Distinguish Rheumatoid Arthritis from Lupus Erythematosus – Diagnosis

This is a chronic, inflammatory autoimmune infection of unknown cause that affects the joints lined by the synovial membrane. However, it is theorized to develop when a genetically susceptible individual encounters an external factor that triggers an autoimmune reaction.

• Rheumatoid arthritis mainly targets the joints while lupus erythematosus can affect multiple organs of the body.
• In rheumatoid arthritis, rheumatoid factor and anti-citrullinated protein antibodies [ACPAs] are found while in lupus erythematosus, antinuclear antibodies [ANAs], anti-dsDNA, and anti-Smith antibodies are usually present.
• Rheumatoid arthritis usually involves symmetric joints while in lupus erythematosus joints may be non-symmetric.

Distinguish Sjogren’S Syndrome from Lupus Erythematosus- Diagnosis

This is an autoimmune disease where the body’s immune system attacks its own fluid-secreting glands or organs, e.g., tears and saliva-secreting glands. Its main symptoms are dry mouth and dry eyes.

• Sjogren’s syndrome primarily affects exocrine glands, which are basically fluid-producing organs while lupus erythematosus affects multiple organs and systems.
• Sjogren’s syndrome symptoms are not manifested in the skin while the symptoms of lupus erythematosus are present as rashes on the skin.

Distinguish Systemic Sclerosis from Lupus Erythematosus – Diagnosis

This is a chronic autoimmune disorder of the connective tissue characterized by degenerative changes and abnormalities in the skin, joints, some internal organs, and blood vessels.

• Systemic sclerosis is characterized by thickening of the skin, especially over the fingers and hand, while lupus erythematosus presents with a malar rash.
• Systemic sclerosis has specific antibodies like anti-centromere and anti-Scl-70 antibodies, while lupus erythematosus has a wide range of antibodies like antinuclear antibodies.

Distinguish Dermatomyositis from Lupus Erythematosus – Diagnosis

This is an inflammatory disease of the muscles that causes muscle weakness and skin rashes. Cause is still unknown.

• Dermatomyositis majorly affects the skin and muscles while lupus erythematosus affects multiple organs of the body.
• Dermatomyositis presents with Gottron’s papules and a heliotrope rash on the skin while lupus erythematosus presents with a malar rash as a skin manifestation.
• Dermatomyositis is associated with specific antibodies like anti-Jo-1 antibodies while lupus erythematosus presents with a wide range of antibodies, e.g., ANAs.

Distinguish Erythema Multiforme from Lupus Erythematosus – Diagnosis

This is an acute and sometimes recurring skin condition theorized to be a type IV hypersensitivity reaction associated with certain triggers, e.g., infections, medications. The main symptom is a rash.

• Erythema multiforme is triggered by infections, medications, or other factors while lupus erythematosus is an autoimmune disease where the immune system attacks its organs.

Red Flags About Lupus Erythematosus

There are two major types of lupus erythematosus. The most common one is systemic lupus erythematosus, which affects multiple organs of the body including skin, joints, kidneys, lungs, brain, and blood cells.
The second one is called Discoid lupus erythematosus, which primarily affects the skin and mostly presents with chronic lesions that result in scarring.
Most of the manifestations of lupus erythematosus are similar to other diseases/conditions; therefore, for a clear and accurate diagnosis, specific diagnostic procedures like CBC, ANA tests, ESR, and CRP tests must be performed.