Systemic lupus erythematosus physical examination

	Systemic lupus erythematosus Microchapters
Home
Patient Information
Overview
Historical Perspective
Classification
Pathophysiology
Causes
Differentiating Systemic lupus erythematosus from other Diseases
Epidemiology and Demographics
Risk Factors
Screening
Natural History, Complications and Prognosis
Diagnosis
Diagnostic Criteria
History and Symptoms
Physical Examination
Laboratory Findings
Electrocardiogram
X Ray
CT
MRI
Echocardiography or Ultrasound
Other Imaging Findings
Other Diagnostic Studies
Treatment
Medical Therapy
Surgery
Primary Prevention
Secondary Prevention
Lupus and Quality of Life
Cost-Effectiveness of Therapy
Future or Investigational Therapies
Case Studies
Case #1
Systemic lupus erythematosus physical examination On the Web
Most recent articles
Most cited articles
Review articles
CME Programs
Powerpoint slides
Images
American Roentgen Ray Society Images of Systemic lupus erythematosus physical examination All Images X-rays Echo & Ultrasound CT Images MRI
Ongoing Trials at Clinical Trials.gov
National Guidelines Clearinghouse
NICE Guidance
FDA on Systemic lupus erythematosus physical examination
on Systemic lupus erythematosus physical examination
Systemic lupus erythematosus physical examination in the news
Blogs onSystemic lupus erythematosus physical examination
Directions to Hospitals Treating Systemic lupus erythematosus
Risk calculators and risk factors for Systemic lupus erythematosus physical examination

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Mahshid Mir, M.D. [2]

Overview

In the earlier stages of the disease, patients appear well, while in the late stages of the disease, patients are clearly ill with multi-organ involvement. The patient may show a wide range of skin manifestations including urticaria, bullous lesions, malar rash, and scarring alopecia. The patient may develop nasal and oral ulcers. Arthritis may lead to a decreased range of motion, joint effusion, and arthralgia. Neurological manifestations including psychosis, cognitive impairment, and hallucinations, may also be present.

Physical Examination

Appearance of the Patient

Patient appears well in the earlier stages of the disease
Patient appears ill in the late stages of the disease due to multi-organ involvement

Vital Signs

Fever higher than 38 after the exclusion of infection
Tachycardia/bradycardia depends on the accompanying complication
Tachypnea/bradypnea depends on the accompanying complication

Skin^[1]^[2]^[3]

Cyanosis
- Secondary to respiratory complications
Jaundice
- Secondary to hepatitis
Pallor
- Secondary to anemia
Generalised erythema
Bruises
- Secondary to thrombocytopenia
Urticaria
Bullous lesions
Sclerodactyly
Skin ulceration
Malar rash: the classic lupus ‘butterfly’ rash
- Erythematous, elevated lesion, pruritic or painful, in a malar distribution, commonly precipitated by exposure to sunlight
Annular or psoriasiform skin lesions
- Small, erythematous, slightly scaly papules that evolve into either a psoriasiform (papulosquamous) or annular form and tend to involve shoulders, forearms, neck, and upper torso
Scarring chronic alopecia
- Mostly present on face, neck, and scalp
Telangiectasias
Dyspigmentation (hyperpigmentation or hypopigmentation) of skin in scar places
Follicular plugging
- Discrete, erythematous, slightly infiltrated plaques covered by a well-formed adherent scale that extends into dilated hair follicles
Nodules
- Can be firm (Lupus profundus) and painful
Photodistributed lesions with chronic pink indurated plaques or broad lesions that are slow to heal (more seen in lupus tumidus)
Thin hair that easily fractures (lupus hair)
Irregularly shaped raised white plaques, areas of erythema, silvery white scarred lesions, and ulcers with surrounding erythema on the soft or hard palate or buccal mucosa
Periungual erythema
- Dilated tortuous loops of capillaries and a prominent subcapillary venous plexus along
- Involves the base of the nail and edges of the upper eyelid

For more pictures of the rash presentation in lupus, click here.

HEENT

Ophthalmology^[4]^[5]
- Nystagmus
- Visual retinal changes from systemic lupus erythematosus cytoid bodies, retinal haemorrhages, serous exudate or haemorrhage in the choroid, optic neuritis (not due to hypertension, drugs or infection)
- Cataract
- Optic nerve atrophy
- Icteric sclera
- Cotton wool spots in the retina in ophthalmoscopic exam
Nasal ulcers^[6]
- Mostly painless
- Mostly in lower nasal septum and bilateral and parallel
- Nasal perforation secondary to vasculitis may happen rarely
Oral ulcers^[7]^[8]
- Mostly painless
- White plaques with areas of erythema, or punched-out erosions or ulcers with surrounding erythema on the soft or hard palate or buccal mucosa

Neck^[9]^[10]

Jugular venous distension
- Secondary to hypertension and cardiac complications
Lymphadenopathy
- Lymph nodes are soft, non-tender, discrete
- Usually detected in the cervical, axillary, and inguinal

Lungs^[11]^[12]^[13]

Fine and coarse crackles upon auscultation of the lung
- May be due to pneumonitis
In case of pleural effusion:
- Asymmetric tactile fremitus
- Asymmetric chest expansion

Heart^[14]^[10]^[15]

Chest tenderness or discomfort upon palpation
- May be due to costochondritis
Diastolic murmur, or systolic murmur >3/6 due to valvular disease
Loud second heart sound (due to pulmonary hypertension)
Loud S1-S2 due to cardiomegaly
Decrease heart sounds if associated with pericardial effusion

Abdomen^[16]^[17]^[18]^[19]

Abdominal distention
Ascites
- Due to nephrotic syndrome
Abdominal pain
- Due to mesentric vasculitis
Hepatomegaly
Splenomegaly
Costo-vertebral angle tenderness

Extremities^[20]^[21]^[22]^[23]^[24]

Clubbing
Cyanosis
Muscle atrophy or weakness
Livedo reticularis
- Reddish-cyanotic, reticular pattern on the skin of the arms, legs, and torso, particularly with cold exposure
Arthritis
- Symmetrical
- Polyarticular
- Mostly involve knees, carpal joints, and joints of the fingers, especially the proximal interphalangeal (PIP) joint
- Decrease range of motion in affected joints
Joints erythema
- Due to synovitis
Joint effusion
Muscle atrophy
Fasciculations in the upper/lower extremity
Claudication
Loss of digit or limb

Neuromuscular^[25]^[26]^[27]^[28]

Patient is usually oriented to persons, place, and time based on the disease course
Cognitive impairment
Hallucinations
- Visual
- Auditory
Memory deficit
- Loose associations
- Impoverished thought content
- Illogical thinking
- Bizarre disorganised or catatonic behaviour

Gallery

Skin: Lupus, systemic erythematosus; Discoid skin lesion in patient with SLE. Image courtesy of Professor Peter Anderson DVM PhD and published with permission © PEIR, University of Alabama at Birmingham, Department of Pathology.^[29]

Skin: ulcer, necrotic; lupus anticoagulant in thigh. Image courtesy of Professor Peter Anderson DVM PhD and published with permission © PEIR, University of Alabama at Birmingham, Department of Pathology.^[29]

Skin: lupus, erythematosus, subacute; Papulosquamous diseases. Image courtesy of Professor Peter Anderson DVM PhD and published with permission © PEIR, University of Alabama at Birmingham, Department of Pathology.^[29]

Skin: lupus, erythematosus; Papulosquamous diseases. Image courtesy of Professor Peter Anderson DVM PhD and published with permission © PEIR, University of Alabama at Birmingham, Department of Pathology.^[29]

Skin: lupus, erythematosus; papulosquamous diseases. Image courtesy of Professor Peter Anderson DVM PhD and published with permission © PEIR, University of Alabama at Birmingham, Department of Pathology.^[29]

Skin: discoid lupus, face. Image courtesy of Professor Peter Anderson DVM PhD and published with permission © PEIR, University of Alabama at Birmingham, Department of Pathology.^[29]

Discoid Lupus Erythematosus

Head

Discoid lupus erythematosus. Adapted from Dermatology Atlas.^[29]
Discoid lupus erythematosus. Adapted from Dermatology Atlas.^[29]
Discoid lupus erythematosus. Adapted from Dermatology Atlas.^[29]
Discoid lupus erythematosus. Adapted from Dermatology Atlas.^[29]
Discoid lupus erythematosus. Adapted from Dermatology Atlas.^[29]
Discoid lupus erythematosus. Adapted from Dermatology Atlas.^[29]
Discoid lupus erythematosus. Adapted from Dermatology Atlas.^[29]
Discoid lupus erythematosus. Adapted from Dermatology Atlas.^[29]
Discoid lupus erythematosus. Adapted from Dermatology Atlas.^[29]
Discoid lupus erythematosus. Adapted from Dermatology Atlas.^[29]
Discoid lupus erythematosus. Adapted from Dermatology Atlas.^[29]
Discoid lupus erythematosus. Adapted from Dermatology Atlas.^[29]

Face

Discoid lupus erythematosus. Adapted from Dermatology Atlas.^[29]
Discoid lupus erythematosus. Adapted from Dermatology Atlas.^[29]
Discoid lupus erythematosus. Adapted from Dermatology Atlas.^[29]
Discoid lupus erythematosus. Adapted from Dermatology Atlas.^[29]
Discoid lupus erythematosus. Adapted from Dermatology Atlas.^[29]
Discoid lupus erythematosus. Adapted from Dermatology Atlas.^[29]
Discoid lupus erythematosus. Adapted from Dermatology Atlas.^[29]
Discoid lupus erythematosus. Adapted from Dermatology Atlas.^[29]
Discoid lupus erythematosus. Adapted from Dermatology Atlas.^[29]
Discoid lupus erythematosus. Adapted from Dermatology Atlas.^[29]
Discoid lupus erythematosus. Adapted from Dermatology Atlas.^[29]
Discoid lupus erythematosus. Adapted from Dermatology Atlas.^[29]
Discoid lupus erythematosus. Adapted from Dermatology Atlas.^[29]
Discoid lupus erythematosus. Adapted from Dermatology Atlas.^[29]
Discoid lupus erythematosus. Adapted from Dermatology Atlas.^[29]
Discoid lupus erythematosus. Adapted from Dermatology Atlas.^[29]
Discoid lupus erythematosus. Adapted from Dermatology Atlas.^[29]
Discoid lupus erythematosus. Adapted from Dermatology Atlas.^[29]
Discoid lupus erythematosus. Adapted from Dermatology Atlas.^[29]
Discoid lupus erythematosus. Adapted from Dermatology Atlas.^[29]
Discoid lupus erythematosus. Adapted from Dermatology Atlas.^[29]
Discoid lupus erythematosus. Adapted from Dermatology Atlas.^[29]
Discoid lupus erythematosus. Adapted from Dermatology Atlas.^[29]
Discoid lupus erythematosus. Adapted from Dermatology Atlas.^[29]
Discoid lupus erythematosus. Adapted from Dermatology Atlas.^[29]
Discoid lupus erythematosus. Adapted from Dermatology Atlas.^[29]
Discoid lupus erythematosus. Adapted from Dermatology Atlas.^[29]
Discoid lupus erythematosus. Adapted from Dermatology Atlas.^[29]
Discoid lupus erythematosus. Adapted from Dermatology Atlas.^[29]
Discoid lupus erythematosus. Adapted from Dermatology Atlas.^[29]
Discoid lupus erythematosus. Adapted from Dermatology Atlas.^[29]

Lupus Erythematosus-Systemic

Lupus Erythematosus Chronicus Disseminatus Superficialis

Lupus Erythematosus Chronicus Disseminatus Superficialis. Adapted from Dermatology Atlas.^[29]
Lupus Erythematosus Chronicus Disseminatus Superficialis. Adapted from Dermatology Atlas.^[29]
Lupus Erythematosus Chronicus Disseminatus Superficialis. Adapted from Dermatology Atlas.^[29]
Lupus Erythematosus Chronicus Disseminatus Superficialis. Adapted from Dermatology Atlas.[29]

Lupus Erythematosus Chronicus Disseminatus Superficialis. Adapted from Dermatology Atlas.^[29]
Lupus Erythematosus Chronicus Disseminatus Superficialis. Adapted from Dermatology Atlas.^[29]
Lupus Erythematosus Chronicus Disseminatus Superficialis. Adapted from Dermatology Atlas.^[29]
Lupus Erythematosus Chronicus Disseminatus Superficialis. Adapted from Dermatology Atlas.^[29]
Lupus Erythematosus Chronicus Disseminatus Superficialis. Adapted from Dermatology Atlas.^[29]

Lupus Erythematosus Chronicus Verrucous

Lupus Erythematosus Chronicus Verrucous. Adapted from Dermatology Atlas.[29]

Lupus Erythematosus Chronicus Verrucous. Adapted from Dermatology Atlas.^[29]
Lupus Erythematosus Chronicus Verrucous. Adapted from Dermatology Atlas.^[29]
Lupus Erythematosus Chronicus Verrucous. Adapted from Dermatology Atlas.^[29]

Lupus Erythematosus Profundus

Lupus Erythematosus Profundu. Adapted from Dermatology Atlas.^[29]
Lupus Erythematosus Profundu. Adapted from Dermatology Atlas.^[29]

Lupus Erythematosus-Subacute Cutaneous Lupus Erythematosus

Lupus Erythematosus-Subacute Cutaneous Lupus Erythematosus. Adapted from Dermatology Atlas.^[29]
Lupus Erythematosus-Subacute Cutaneous Lupus Erythematosus. Adapted from Dermatology Atlas.^[29]
Lupus Erythematosus-Subacute Cutaneous Lupus Erythematosus. Adapted from Dermatology Atlas.^[29]
Lupus Erythematosus-Subacute Cutaneous Lupus Erythematosus. Adapted from Dermatology Atlas.^[29]
Lupus Erythematosus-Subacute Cutaneous Lupus Erythematosus. Adapted from Dermatology Atlas.^[29]

Lupus Vulgaris

Lupus Vulgaris. Adapted from Dermatology Atlas.^[29]
Lupus Vulgaris. Adapted from Dermatology Atlas.^[29]

References

↑ Parodi A, Cozzani E (2014). "Cutaneous manifestations of lupus erythematosus". G Ital Dermatol Venereol. 149 (5): 549–54. PMID 25077888.
↑ Szczęch J, Rutka M, Samotij D, Zalewska A, Reich A (2016). "Clinical characteristics of cutaneous lupus erythematosus". Postepy Dermatol Alergol. 33 (1): 13–7. doi:10.5114/pdia.2014.44031. PMC 4793050. PMID 26985173.
↑ Walling HW, Sontheimer RD (2009). "Cutaneous lupus erythematosus: issues in diagnosis and treatment". Am J Clin Dermatol. 10 (6): 365–81. doi:10.2165/11310780-000000000-00000. PMID 19824738.
↑ Preble JM, Silpa-archa S, Foster CS (2015). "Ocular involvement in systemic lupus erythematosus". Curr Opin Ophthalmol. 26 (6): 540–5. doi:10.1097/ICU.0000000000000209. PMID 26367085.
↑ Silpa-archa S, Lee JJ, Foster CS (2016). "Ocular manifestations in systemic lupus erythematosus". Br J Ophthalmol. 100 (1): 135–41. doi:10.1136/bjophthalmol-2015-306629. PMID 25904124.
↑ Robson AK, Burge SM, Millard PR (1992). "Nasal mucosal involvement in lupus erythematosus". Clin Otolaryngol Allied Sci. 17 (4): 341–3. PMID 1526055.
↑ Anyanwu CO, Ang CC, Werth VP (2013). "Oral mucosal involvement in bullous lupus". Arthritis Rheum. 65 (10): 2622. doi:10.1002/art.38051. PMC 4333153. PMID 23780804.
↑ Ranginwala AM, Chalishazar MM, Panja P, Buddhdev KP, Kale HM (2012). "Oral discoid lupus erythematosus: A study of twenty-one cases". J Oral Maxillofac Pathol. 16 (3): 368–73. doi:10.4103/0973-029X.102487. PMC 3519212. PMID 23248469.
↑ Melikoglu MA, Melikoglu M (2008). "The clinical importance of lymphadenopathy in systemic lupus erythematosus". Acta Reumatol Port. 33 (4): 402–6. PMID 19107085.
↑ ^10.0 ^10.1 Sacre K, Escoubet B, Pasquet B, Chauveheid MP, Zennaro MC, Tubach F, Papo T (2014). "Increased arterial stiffness in systemic lupus erythematosus (SLE) patients at low risk for cardiovascular disease: a cross-sectional controlled study". PLoS ONE. 9 (4): e94511. doi:10.1371/journal.pone.0094511. PMC 3983200. PMID 24722263.
↑ Torre O, Harari S (2011). "Pleural and pulmonary involvement in systemic lupus erythematosus". Presse Med. 40 (1 Pt 2): e19–29. doi:10.1016/j.lpm.2010.11.004. PMID 21194884.
↑ Salvati F (2015). "[The involvement of pulmonary interstitial tissue in multisystemic lupus erythematosus: interdisciplinarity and role of the pneumologists]". Clin Ter (in Italian). 166 (5): 205–7. PMID 26550810.
↑ Alamoudi OS, Attar SM (2015). "Pulmonary manifestations in systemic lupus erythematosus: association with disease activity". Respirology. 20 (3): 474–80. doi:10.1111/resp.12473. PMC 4418345. PMID 25639532.
↑ Mak A, Kow NY (2014). "Imbalance between endothelial damage and repair: a gateway to cardiovascular disease in systemic lupus erythematosus". Biomed Res Int. 2014: 178721. doi:10.1155/2014/178721. PMC 3984775. PMID 24790989.
↑ Canpolat N, Kasapcopur O, Caliskan S, Gokalp S, Bor M, Tasdemir M, Sever L, Arisoy N (2013). "Ambulatory blood pressure and subclinical cardiovascular disease in patients with juvenile-onset systemic lupus erythematosus". Pediatr. Nephrol. 28 (2): 305–13. doi:10.1007/s00467-012-2317-3. PMID 23052654.
↑ Tian XP, Zhang X (2010). "Gastrointestinal involvement in systemic lupus erythematosus: insight into pathogenesis, diagnosis and treatment". World J. Gastroenterol. 16 (24): 2971–7. PMC 2890936. PMID 20572299.
↑ Alves SC, Fasano S, Isenberg DA (2016). "Autoimmune gastrointestinal complications in patients with systemic lupus erythematosus: case series and literature review". Lupus. 25 (14): 1509–1519. doi:10.1177/0961203316655210. PMID 27329649.
↑ Fawzy M, Edrees A, Okasha H, El Ashmaui A, Ragab G (2016). "Gastrointestinal manifestations in systemic lupus erythematosus". Lupus. 25 (13): 1456–1462. doi:10.1177/0961203316642308. PMID 27055518.
↑ Li Z, Xu D, Wang Z, Wang Y, Zhang S, Li M, Zeng X (2017). "Gastrointestinal system involvement in systemic lupus erythematosus". Lupus: 961203317707825. doi:10.1177/0961203317707825. PMID 28523968.
↑ Zoma A (2004). "Musculoskeletal involvement in systemic lupus erythematosus". Lupus. 13 (11): 851–3. doi:10.1191/0961203303lu2021oa. PMID 15580980.
↑ Gabba A, Piga M, Vacca A, Porru G, Garau P, Cauli A, Mathieu A (2012). "Joint and tendon involvement in systemic lupus erythematosus: an ultrasound study of hands and wrists in 108 patients". Rheumatology (Oxford). 51 (12): 2278–85. doi:10.1093/rheumatology/kes226. PMID 22956550.
↑ Grossman JM (2009). "Lupus arthritis". Best Pract Res Clin Rheumatol. 23 (4): 495–506. doi:10.1016/j.berh.2009.04.003. PMID 19591780.
↑ Zhu KK, Xu WD, Pan HF, Zhang M, Ni J, Ge FY, Ye DQ (2014). "The risk factors of avascular necrosis in patients with systemic lupus erythematosus: a meta-analysis". Inflammation. 37 (5): 1852–64. doi:10.1007/s10753-014-9917-y. PMID 24862229.
↑ Voulgari PV, Kosta P, Argyropoulou MI, Drosos AA (2013). "Avascular necrosis in a patient with systemic lupus erythematosus". Joint Bone Spine. 80 (6): 665. doi:10.1016/j.jbspin.2013.03.018. PMID 23731640.
↑ Cojocaru IM, Cojocaru M, Tănăsescu R, Burcin C, Atanasiu AN, Silosi I (2008). "Detection of autoantibodies to ribosome P in lupus patients with neurological involvement". Rom J Intern Med. 46 (3): 239–42. PMID 19366083.
↑ Madrane S, Ribi C (2012). "[Central neuropsychiatric involvement in systemic lupus erythematosus]". Rev Med Suisse (in French). 8 (337): 848–53. PMID 22594009.
↑ Sivri A, Hasçelik Z, Celiker R, Başgöze O (1995). "Early detection of neurological involvement in systemic lupus erythematosus patients". Electromyogr Clin Neurophysiol. 35 (4): 195–9. PMID 7555923.
↑ Juncal Gallego L, Almuíña Simón C, Muíños Esparza LF, Díaz Soto R, Ramil Fraga C, Quiroga Ordóñez E (2009). "[Systemic lupus erythematosus with fulminant neurological involvement]". An Pediatr (Barc) (in Spanish; Castilian). 70 (2): 202–4. doi:10.1016/j.anpedi.2008.09.009. PMID 19217587.
↑ ^29.00 ^29.01 ^29.02 ^29.03 ^29.04 ^29.05 ^29.06 ^29.07 ^29.08 ^29.09 ^29.10 ^29.11 ^29.12 ^29.13 ^29.14 ^29.15 ^29.16 ^29.17 ^29.18 ^29.19 ^29.20 ^29.21 ^29.22 ^29.23 ^29.24 ^29.25 ^29.26 ^29.27 ^29.28 ^29.29 ^29.30 ^29.31 ^29.32 ^29.33 ^29.34 ^29.35 ^29.36 ^29.37 ^29.38 ^29.39 ^29.40 ^29.41 ^29.42 ^29.43 ^29.44 ^29.45 ^29.46 ^29.47 ^29.48 ^29.49 ^29.50 ^29.51 ^29.52 ^29.53 ^29.54 ^29.55 ^29.56 ^29.57 ^29.58 ^29.59 ^29.60 ^29.61 ^29.62 ^29.63 ^29.64 ^29.65 ^29.66 ^29.67 ^29.68 ^29.69 ^29.70 ^29.71 ^29.72 ^29.73 ^29.74 ^29.75 ^29.76 ^29.77 "Dermatology Atlas".

[pmid25077888-1] Parodi A, Cozzani E (2014). "Cutaneous manifestations of lupus erythematosus". G Ital Dermatol Venereol. 149 (5): 549–54. PMID 25077888.

[pmid26985173-2] Szczęch J, Rutka M, Samotij D, Zalewska A, Reich A (2016). "Clinical characteristics of cutaneous lupus erythematosus". Postepy Dermatol Alergol. 33 (1): 13–7. doi:10.5114/pdia.2014.44031. PMC 4793050. PMID 26985173.

[pmid19824738-3] Walling HW, Sontheimer RD (2009). "Cutaneous lupus erythematosus: issues in diagnosis and treatment". Am J Clin Dermatol. 10 (6): 365–81. doi:10.2165/11310780-000000000-00000. PMID 19824738.

[pmid26367085-4] Preble JM, Silpa-archa S, Foster CS (2015). "Ocular involvement in systemic lupus erythematosus". Curr Opin Ophthalmol. 26 (6): 540–5. doi:10.1097/ICU.0000000000000209. PMID 26367085.

[pmid25904124-5] Silpa-archa S, Lee JJ, Foster CS (2016). "Ocular manifestations in systemic lupus erythematosus". Br J Ophthalmol. 100 (1): 135–41. doi:10.1136/bjophthalmol-2015-306629. PMID 25904124.

[pmid1526055-6] Robson AK, Burge SM, Millard PR (1992). "Nasal mucosal involvement in lupus erythematosus". Clin Otolaryngol Allied Sci. 17 (4): 341–3. PMID 1526055.

[pmid23780804-7] Anyanwu CO, Ang CC, Werth VP (2013). "Oral mucosal involvement in bullous lupus". Arthritis Rheum. 65 (10): 2622. doi:10.1002/art.38051. PMC 4333153. PMID 23780804.

[pmid23248469-8] Ranginwala AM, Chalishazar MM, Panja P, Buddhdev KP, Kale HM (2012). "Oral discoid lupus erythematosus: A study of twenty-one cases". J Oral Maxillofac Pathol. 16 (3): 368–73. doi:10.4103/0973-029X.102487. PMC 3519212. PMID 23248469.

[pmid19107085-9] Melikoglu MA, Melikoglu M (2008). "The clinical importance of lymphadenopathy in systemic lupus erythematosus". Acta Reumatol Port. 33 (4): 402–6. PMID 19107085.

[pmid24722263-10] 10.0 ^10.1 Sacre K, Escoubet B, Pasquet B, Chauveheid MP, Zennaro MC, Tubach F, Papo T (2014). "Increased arterial stiffness in systemic lupus erythematosus (SLE) patients at low risk for cardiovascular disease: a cross-sectional controlled study". PLoS ONE. 9 (4): e94511. doi:10.1371/journal.pone.0094511. PMC 3983200. PMID 24722263.

[pmid21194884-11] Torre O, Harari S (2011). "Pleural and pulmonary involvement in systemic lupus erythematosus". Presse Med. 40 (1 Pt 2): e19–29. doi:10.1016/j.lpm.2010.11.004. PMID 21194884.

[pmid26550810-12] Salvati F (2015). "[The involvement of pulmonary interstitial tissue in multisystemic lupus erythematosus: interdisciplinarity and role of the pneumologists]". Clin Ter (in Italian). 166 (5): 205–7. PMID 26550810.

[pmid25639532-13] Alamoudi OS, Attar SM (2015). "Pulmonary manifestations in systemic lupus erythematosus: association with disease activity". Respirology. 20 (3): 474–80. doi:10.1111/resp.12473. PMC 4418345. PMID 25639532.

[pmid24790989-14] Mak A, Kow NY (2014). "Imbalance between endothelial damage and repair: a gateway to cardiovascular disease in systemic lupus erythematosus". Biomed Res Int. 2014: 178721. doi:10.1155/2014/178721. PMC 3984775. PMID 24790989.

[pmid23052654-15] Canpolat N, Kasapcopur O, Caliskan S, Gokalp S, Bor M, Tasdemir M, Sever L, Arisoy N (2013). "Ambulatory blood pressure and subclinical cardiovascular disease in patients with juvenile-onset systemic lupus erythematosus". Pediatr. Nephrol. 28 (2): 305–13. doi:10.1007/s00467-012-2317-3. PMID 23052654.

[pmid20572299-16] Tian XP, Zhang X (2010). "Gastrointestinal involvement in systemic lupus erythematosus: insight into pathogenesis, diagnosis and treatment". World J. Gastroenterol. 16 (24): 2971–7. PMC 2890936. PMID 20572299.

[pmid27329649-17] Alves SC, Fasano S, Isenberg DA (2016). "Autoimmune gastrointestinal complications in patients with systemic lupus erythematosus: case series and literature review". Lupus. 25 (14): 1509–1519. doi:10.1177/0961203316655210. PMID 27329649.

[pmid27055518-18] Fawzy M, Edrees A, Okasha H, El Ashmaui A, Ragab G (2016). "Gastrointestinal manifestations in systemic lupus erythematosus". Lupus. 25 (13): 1456–1462. doi:10.1177/0961203316642308. PMID 27055518.

[pmid28523968-19] Li Z, Xu D, Wang Z, Wang Y, Zhang S, Li M, Zeng X (2017). "Gastrointestinal system involvement in systemic lupus erythematosus". Lupus: 961203317707825. doi:10.1177/0961203317707825. PMID 28523968.

[pmid15580980-20] Zoma A (2004). "Musculoskeletal involvement in systemic lupus erythematosus". Lupus. 13 (11): 851–3. doi:10.1191/0961203303lu2021oa. PMID 15580980.

[pmid22956550-21] Gabba A, Piga M, Vacca A, Porru G, Garau P, Cauli A, Mathieu A (2012). "Joint and tendon involvement in systemic lupus erythematosus: an ultrasound study of hands and wrists in 108 patients". Rheumatology (Oxford). 51 (12): 2278–85. doi:10.1093/rheumatology/kes226. PMID 22956550.

[pmid19591780-22] Grossman JM (2009). "Lupus arthritis". Best Pract Res Clin Rheumatol. 23 (4): 495–506. doi:10.1016/j.berh.2009.04.003. PMID 19591780.

[pmid24862229-23] Zhu KK, Xu WD, Pan HF, Zhang M, Ni J, Ge FY, Ye DQ (2014). "The risk factors of avascular necrosis in patients with systemic lupus erythematosus: a meta-analysis". Inflammation. 37 (5): 1852–64. doi:10.1007/s10753-014-9917-y. PMID 24862229.

[pmid23731640-24] Voulgari PV, Kosta P, Argyropoulou MI, Drosos AA (2013). "Avascular necrosis in a patient with systemic lupus erythematosus". Joint Bone Spine. 80 (6): 665. doi:10.1016/j.jbspin.2013.03.018. PMID 23731640.

[pmid19366083-25] Cojocaru IM, Cojocaru M, Tănăsescu R, Burcin C, Atanasiu AN, Silosi I (2008). "Detection of autoantibodies to ribosome P in lupus patients with neurological involvement". Rom J Intern Med. 46 (3): 239–42. PMID 19366083.

[pmid22594009-26] Madrane S, Ribi C (2012). "[Central neuropsychiatric involvement in systemic lupus erythematosus]". Rev Med Suisse (in French). 8 (337): 848–53. PMID 22594009.

[pmid7555923-27] Sivri A, Hasçelik Z, Celiker R, Başgöze O (1995). "Early detection of neurological involvement in systemic lupus erythematosus patients". Electromyogr Clin Neurophysiol. 35 (4): 195–9. PMID 7555923.

[pmid19217587-28] Juncal Gallego L, Almuíña Simón C, Muíños Esparza LF, Díaz Soto R, Ramil Fraga C, Quiroga Ordóñez E (2009). "[Systemic lupus erythematosus with fulminant neurological involvement]". An Pediatr (Barc) (in Spanish; Castilian). 70 (2): 202–4. doi:10.1016/j.anpedi.2008.09.009. PMID 19217587.

[Dermatology_Atlas-29] 29.00 ^29.01 ^29.02 ^29.03 ^29.04 ^29.05 ^29.06 ^29.07 ^29.08 ^29.09 ^29.10 ^29.11 ^29.12 ^29.13 ^29.14 ^29.15 ^29.16 ^29.17 ^29.18 ^29.19 ^29.20 ^29.21 ^29.22 ^29.23 ^29.24 ^29.25 ^29.26 ^29.27 ^29.28 ^29.29 ^29.30 ^29.31 ^29.32 ^29.33 ^29.34 ^29.35 ^29.36 ^29.37 ^29.38 ^29.39 ^29.40 ^29.41 ^29.42 ^29.43 ^29.44 ^29.45 ^29.46 ^29.47 ^29.48 ^29.49 ^29.50 ^29.51 ^29.52 ^29.53 ^29.54 ^29.55 ^29.56 ^29.57 ^29.58 ^29.59 ^29.60 ^29.61 ^29.62 ^29.63 ^29.64 ^29.65 ^29.66 ^29.67 ^29.68 ^29.69 ^29.70 ^29.71 ^29.72 ^29.73 ^29.74 ^29.75 ^29.76 ^29.77 "Dermatology Atlas".

[1]

[2]

[3]

[4]

[5]

[6]

[7]

[8]

[9]

[10]

[11]

[12]

[13]

[14]

[15]

[16]

[17]

[18]

[19]

[20]

[21]

[22]

[23]

[24]

[25]

[26]

[27]

[28]

[29]

Systemic lupus erythematosus physical examination

Overview

Physical Examination

Appearance of the Patient

Vital Signs

Skin[1][2][3]

HEENT

Neck[9][10]

Lungs[11][12][13]

Heart[14][10][15]

Abdomen[16][17][18][19]

Extremities[20][21][22][23][24]

Neuromuscular[25][26][27][28]

Gallery

Discoid Lupus Erythematosus

Head

Face

Lupus Erythematosus-Systemic

Face

Extremity

Trunk

Lupus Erythematosus Chronicus Disseminatus Superficialis

Lupus Erythematosus Chronicus Verrucous

Lupus Erythematosus Profundus

Lupus Erythematosus-Subacute Cutaneous Lupus Erythematosus

Lupus Vulgaris

References

Navigation menu

Skin^[1]^[2]^[3]

Neck^[9]^[10]

Lungs^[11]^[12]^[13]

Heart^[14]^[10]^[15]

Abdomen^[16]^[17]^[18]^[19]

Extremities^[20]^[21]^[22]^[23]^[24]

Neuromuscular^[25]^[26]^[27]^[28]