Facial swelling with erythema represents quite an unusual manifestation of chronic cutaneous lupus erythematosus. Dermatomyositis, systemic lupus and Morbihan disease are the main differential diagnoses.
Cutaneous involvement in lupus erythematosus (LE) is quite common and includes a broad range of manifestations. Although facial swelling with erythema is a common presentation of systemic lupus erythematosus (SLE), it is quite an infrequent manifestation of exclusively cutaneous lupus.
The most recognizable skin conditions are facial rashes. They typically lead to a diagnosis of Lupus or dermatomyositis, although other diseases could be possible or co-exist. The classic “butterfly rash” covers the cheeks and nose and is often a first sign of Lupus.
Lupus facial rash
A typical sign of lupus is a red, butterfly-shaped rash over your cheeks and nose, often following exposure to sunlight.
Vasculitis: Vasculitis involves inflammation of blood vessels, leading to various symptoms depending on the affected organs. The diagnosis often requires imaging studies and biopsies, making it one of the more challenging autoimmune diseases to identify.
Lupus Nephritis. Lupus nephritis is kidney inflammation due to lupus, an autoimmune disease. Symptoms can include fluid buildup in your body and increased urine output. About half of adults and 80% of children with lupus will develop lupus nephritis.
Your face can get a rounded, “moon-faced” swollen look from this rare condition. It happens when your adrenal glands make too much of the “stress hormone” cortisol for too long. You might also have more fat around your belly and neck, weaker muscles, and purplish bruises or stretch marks.
But other troubling, less common symptoms of multiple sclerosis can also develop — such as facial swelling. “My face and legs swell every day no matter what I do,” shared one MyMSTeam member.
“Cortisol face” isn't an official diagnosis
It's a combination of fat accumulation and soft issue swelling, associated with thinning of the skin. All of this can lead to a more round-looking, puffy face with pinker cheeks.
Common face swelling causes include: Allergic reactions, including hay fever, bee stings or food allergies. Drug reactions, including medication allergies and side effects. (Prednisone can cause facial swelling in some people, for example.)
The 11 criteria included were malar rash, discoid rash, photosensitivity, alopecia, Raynaud phenomenon, oral/nasal ulcers, arthritis (non-erosive arthritis involving 2 or more peripheral joints), serositis (pleurisy or pericarditis), renal disease (proteinuria greater than 500 mg daily or cellular RBC, granular, ...
Lupus can also cause other problems in the abdomen, including peritonitis (inflammation of the abdominal lining) and ascites (a build-up of fluids in the abdomen). Symptoms of peritonitis and ascites include: Abdominal pain and swelling. Nausea and vomiting.
Lupus involves periodic flare-ups, in which symptoms intensify, and remission, in which symptoms lessen or disappear. The most common symptoms include fatigue, painful and swollen joints, skin rashes—most notably, a butterfly-shaped rash across the face—unexplained fever, and mouth or nose ulcers.
The most common type of lupus, systemic lupus erythematosus (SLE), can cause dry, coarse hair to develop along the hairline. These dry, coarse hairs break off easily, causing the sparse-looking hair known as lupus hair. Other types of hair loss also develop.
The hallmark symptom of Sjögren syndrome is dry mouth and keratoconjunctivitis sicca (dry eyes). Vaginal dryness, dry skin, and dry nose may also occur. Other organs of the body may also be affected, including the kidneys, blood vessels, lungs, liver, pancreas, and brain.
Other skin conditions that sometimes mimic the skin problems of lupus include melasma, psoriasis, eczema (atopic dermatitis), and facial seborrheic dermatitis. A dermatologist can diagnose these skin conditions. The symptoms of clinical depression can mimic lupus symptoms, and vice versa.
Lupus Symptom: Raynaud's
Their fingers and toes become painful, numb, and tingly in response to cold temperatures or emotional stress. This happens when small blood vessels spasm and restrict blood flow to the area. During an attack, the fingers and toes may turn white or blue.
Inflammation of Joints and Tissues
Lupus-related inflammation can affect the joints and soft tissues of the spine, leading to pain and discomfort.
Asherson's syndrome is an extremely rare autoimmune disorder characterized by the development, over a period of hours, days or weeks, of rapidly progressive blood clots affecting multiple organ systems of the body.