Answer: Because of the difficulty in establishing an unequivocal diagnosis, rates of CNS features cross a broad range. Neuropsychiatric manifestations of lupus may occur in around 70% of patients. Examples include psychosis (5%); cranial, autonomic, and peripheral neuropathies; migraine headaches; seizure; aseptic meningitis; pseudotumor cerebri; chorea; and cerebral infarction. Rarely, transverse myelitis has been observed. [...]

Answer: Small infarcts and hemorrhages are more commonly the source for the neuropsychiatric features of lupus than vasculitis. In fact, vasculitis, as suggested by such commonly used designations as “lupus cerebritis,” occur in < 15% of patients. KEY POINTS: SPECIFIC RHEUMATOLOGIC DISEASES RA increases mortality. Mixed connective tissue disease is a specific diagnosis with features [...]

Answer: GI manifestations may be present in up to 50% of patients with SLE. Anorexia, nausea, and vomiting are among the most common. Oral ulcerations (most commonly buccal erosions) were identified in 40% of one group of patients. Esophageal involvement, as esophagitis, esophageal ulceration, or esophageal dysmotility, seems to correlate with the presence of Raynaud’s [...]

Answer: Some consider this cutaneous eruption on a spectrum between chronic discoid lupus and acute cutaneous lupus. The lesions generally occur on the shoulders, upper chest, and neck and are symmetric and nonscarring. They can be annular and resemble psoriasis. Between 25% and 50% of patients have constitutional symptoms, and they may have circulating antibodies [...]

Answer: Symmetric, superficial, nonscarring annular lesions of the shoulders, upper arms, and back are the classic lesions of subacute cutaneous lupus. Nonscarring alopecia often occurs concurrently. Patients may or may not have circulating anti-Ro antibodies. Lesions are highly photosensitive. Reference: Harris ED, Budd RC, Firestein GS, et al (eds): Kelley’s Textbook of Rheumatology, 7th ed. [...]