According to the Lupus Foundation of America, there are four main types of lupus. Understanding which type you have can help you and your health care provider develop the most effective treatment plan.

Lupus is an autoimmune disease that can cause a range of symptoms throughout the body. Each person’s experience with the disease is unique. For some, lupus symptoms may not fit neatly into a single type, and certain forms of lupus even have additional subtypes. Symptoms can also change over time, which may lead to a reclassification of type and adjustment in treatment.

The types systemic lupus erythematosus (SLE) and cutaneous lupus erythematosus (CLE) can also behave like points on a continuum; for instance, a milder form may progress to a more severe one.

Here’s a closer look at the four main types of lupus.

1. Systemic Lupus Erythematosus

Systemic lupus erythematosus is the most common form of lupus, accounting for 70 percent of cases. The word “systemic” means the disease is widespread throughout the body, attacking different types of tissue. In severe cases, SLE can attack the kidneys, heart, brain, nerves, and blood vessels.

Common symptoms of SLE include:

• Extreme fatigue
• Photosensitivity (sensitivity to sun exposure)
• Hair loss
• Skin rashes
• Joint pain or swelling
• Chest pain when breathing deeply
• Headaches

Kidney disease caused by lupus is known as lupus nephritis. Up to 50 percent of people with lupus eventually develop kidney problems. Kidney damage usually isn’t noticeable until it becomes severe. Regular blood and urine tests can detect kidney problems earlier.

People whose lupus primarily affects the brain and nerves can be said to have central nervous system (CNS) lupus or neuro-lupus. The CNS refers to the brain and spinal cord, which control most of the body’s functions and responses. CNS lupus can cause:

• Seizures — Sudden, uncontrolled electrical disturbances in the brain
• Strokes — Interruption of blood flow to the brain, leading to neurological symptoms
• Cognitive dysfunction — Problems with thinking, memory, or concentration, sometimes called “lupus brain fog”
• Peripheral neuropathy — Numbness or tingling, usually in the hands and feet, caused by nerve damage
• Psychotic episodes — Periods of disconnection from reality, which may include hallucinations or delusions

It isn’t uncommon for people with systemic lupus to have the characteristic malar (butterfly-shaped) rash on their faces. People with SLE may also have discoid or other forms of cutaneous lupus (types of lupus that primarily affect the skin).

2. Cutaneous Lupus Erythematosus

Cutaneous lupus erythematosus mostly affects the skin. People with cutaneous forms of lupus are less likely to have systemic lupus. However, about 10 percent of those with skin-only lupus will eventually develop systemic disease. Because lupus can sometimes cause asymptomatic (silent) damage in other parts of the body, people with cutaneous lupus may still need regular follow-ups to monitor for signs of systemic disease.

The most common type of cutaneous lupus is discoid lupus erythematosus (DLE), also known as chronic cutaneous lupus erythematosus. This type of lupus causes round or oval lesions of thick, scaly skin. When DLE lesions (areas of damaged skin) are limited to the head and neck, the likelihood of developing systemic lupus is lower.

In subacute cutaneous lupus erythematosus (SCLE), scaly patches and ring-shaped lesions tend to develop on areas including the chest, back, and neck. They may also appear on the face and arms. People with SCLE don’t usually develop severe systemic disease, though joint pain and stiffness are common.

The malar rash, or butterfly rash, is typical of acute cutaneous lupus erythematosus (ACLE). In ACLE, which is also common in people with systemic lupus, patches appear on the cheeks and across the nose that form the shape of a butterfly. Discolored patches can also occur on other parts of the body. These patches are photosensitive (reactive to sunlight and tanning beds).

The color of lupus skin patches varies by skin tone. On lighter skin, the affected areas may look red or pink. On darker skin, they might look dark purple or dark brown.

3. Drug-Induced Lupus Erythematosus

Certain medications can cause the immune system to overreact, producing a condition resembling lupus called drug-induced lupus erythematosus. The more common drugs that cause this reaction include:

• Hydralazine (treats high blood pressure)
• Procainamide (treats irregular heart rhythms)
• Quinidine (treats irregular heart rhythms)

Some antiseizure medications and tumor necrosis factor-alpha (TNF-alpha) inhibitors taken for autoimmune conditions can also trigger drug-induced lupus.

Drug-induced lupus can take several months or even years to develop after a person has started the medication. Symptoms often resemble those of systemic lupus and may include:

• Rash
• Skin lesions
• Joint pain
• Photosensitivity
• Inflammation in the lungs, heart, or kidneys

However, unlike systemic lupus, symptoms of drug-induced lupus typically go away within six months of stopping the medication. If you have questions or concerns about a medication you’re taking, talk to your health care provider.

4. Neonatal Lupus

Neonatal lupus, sometimes called congenital lupus, is not a true form of lupus in infants. Rather, it’s a rare condition that occurs when specific autoantibodies from a pregnant person with lupus or another autoimmune condition cross the placenta and affect the fetus. These antibodies can cause a rash resembling a lupus rash, as well as other symptoms that are mostly temporary. In addition to developing the rash, a baby with neonatal lupus may have low blood cell counts or liver problems, which typically resolve within the first few months of life.

In rare cases, neonatal lupus can cause a serious heart condition known as congenital heart block. This occurs when the mother’s antibodies interfere with the baby’s heart rhythm, creating a blockage that slows down or disrupts the heartbeat. If not detected and treated early, congenital heart block can be life-threatening and may require medication or surgery after birth.

People who are pregnant and have lupus or related autoimmune conditions are encouraged to have regular monitoring with both a rheumatologist and a maternal-fetal medicine specialist. This can help detect and manage any potential risks to the baby.

Talk to Your Doctor

If you have symptoms of lupus or questions about a possible lupus diagnosis, schedule an appointment with a health care professional. Lupus is often treated by rheumatologists, specialists in autoimmune diseases that affect the joints, muscles, and other tissues. Depending on your symptoms, they may refer you to other specialists, such as a dermatologist (for skin issues) or a cardiologist (for heart-related concerns), to ensure you get comprehensive care.

Talk With Others Who Understand

MyLupusTeam is the social network for people with lupus and their loved ones. On MyLupusTeam, more than 232,000 members come together to ask questions, give advice, and share their stories with others who understand life with lupus.

What type of lupus do you have? What were the symptoms that led to your diagnosis? Share your experience in the comments below, or start a conversation by posting on your Activities page.