What Causes An Autoimmune Rash? 10 Possible Conditions

Table of Contents

What autoimmune conditions cause a rash on the skin? These are the most common autoimmune diseases that may cause rashes on your skin:

  • Lupus
  • Sjogren’s syndrome
  • Dermatomyositis
  • Psoriasis
  • Eczema
  • Hypothyroidism & myxedema
  • Celiac disease
  • Scleroderma
  • Lichen planus
  • Behçet’s disease

An autoimmune disease occurs when your body’s immune system attacks healthy cells within the body. This dysfunctional immune response may lead to various symptoms, like hair loss, skin rash, or even joint pain.

More than 20 million Americans suffer from autoimmune diseases such as rheumatoid arthritis or Hashimoto’s thyroiditis. If you are experiencing unexplained itching, rashes, or skin sores, you should consult your healthcare provider.

Why do autoimmune conditions cause a rash? Autoimmune conditions may cause a rash because they trigger inflammation in skin cells. These diseases are often characterized by chronic inflammation in your internal organs, your skin, and everywhere in between.

What do autoimmune rashes look like? Autoimmune rashes can look like scaly red patches, purplish bumps, or more. The appearance of autoimmune rashes will be different, depending on which autoimmune condition is triggering the skin rash. 

For example, cutaneous lupus may cause a scaly red patch that does not hurt or itch. Scalp psoriasis may cause plaque buildup that results in hair loss. Lichen planus may cause purplish, itchy, flat bumps on your skin.

Learn more about the autoimmune conditions that may cause skin rashes. Here are 10 of the conditions that commonly cause autoimmune rashes and pictures of what these autoimmune skin disorders might look like on the average patient.

Lupus

Two-thirds of lupus patients will develop a skin condition. Skin disease in lupus may present as rashes or sores and lesions.

Where it is: Usually sun-exposed skin, including the face, neck, and arms.

What it looks like: On the face, a butterfly shape across the nose and cheeks. On other body parts, a red, ring-like shape with some scaling, often confused with ringworm or psoriasis.

Lupus may also cause cherry angiomas, bright red, raised bumps on the skin. These are groups of blood vessels just under the surface of the skin, hence the bright red color.

Is it permanent? Lupus rashes can last anywhere from a few days to years, but they are not permanent. Cherry angiomas will not go away on their own and require treatment by a qualified clinician.

What autoimmune disease causes sun rash? Lupus is the autoimmune disease that is most likely to cause a sun-related rash. Up to 70% of lupus cases are worsened by sun exposure or extended time under fluorescent lights, a condition known as “photosensitivity.” Many lupus-related rashes appear on areas of the skin most heavily exposed to sunlight.

Unfortunately, people with lupus may also experience systemic flare-ups after sun exposure. Symptoms may include skin inflammation as well as fatigue, joint pain, and more.

autoimmune rash caused by lupus

Cutaneous lupus refers to a form of lupus that only affects the skin. (When people say “lupus,” they’re usually talking about systemic lupus erythematosus (SLE), which is different from cutaneous lupus.) You can have multiple forms of lupus or only one form.

The 3 types of cutaneous lupus:

  1. Acute cutaneous lupus often causes a butterfly rash (AKA malar rash) on your cheeks. This should not lead to scarring. However, this area will be sensitive to sunlight, and it may look like a sunburn.
  2. Subacute cutaneous lupus also occurs mostly on sun-exposed areas of your skin. The affected areas should not scar or itch. However, the affected areas may become discolored and scaly.
  3. Chronic cutaneous lupus is sometimes known as discoid lupus, even though “discoid” is the most common form of chronic cutaneous lupus among many. Discoid lupus is very sensitive to sunlight and even fluorescent light, producing small amounts of ultraviolet radiation. Discoid lupus may eventually lead to discoloration and scarring, though typically discoid lesions still do not itch or hurt. Discoid lesions on the head can cause hair to fall out permanently.

Neonatal lupus is a very rare condition that affects infants of mothers who have some form of lupus. At birth, the infant may exhibit a skin rash, low blood cell count, liver problems, or a slow heartbeat.

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Sjögren’s Syndrome

Sjögren’s syndrome is an autoimmune disease that can cause dry eyes and dry mouth. Mainly affecting women over 40, Sjögren’s syndrome impacts up to 3 million Americans.

Individuals with Sjögren’s may develop a skin rash.

Where it is: Areas exposed to the sun and lower legs can be affected.

What it looks like: Sjögren’s syndrome-related skin problems may present as:

  • Dry, rough skin (AKA xerosis)
  • Blood spots on your legs (AKA purpura) due to blood vessel inflammation (AKA vasculitis)
  • Purple-to-red skin rash that does not lighten under pressure
  • Red, ring-shaped skin lesions around a pale center (AKA annular erythema)

Is it permanent? While there is currently no cure for Sjögren’s, flare-ups may fluctuate or go into remission with treatment.

skin rash caused by Sjögren’s syndrome

If you experience purpura or annular erythema, schedule a visit with your doctor or dermatologist right away.

Although Sjögren’s syndrome does not seem to reduce life expectancy, it can reduce your quality of life. For instance, Sjögren’s may lead to urinary tract infections. If it causes dry mouth, you may develop gum disease and cavities, which may drastically reduce your quality of life.

Dermatomyositis

Dermatomyositis is a very rare autoimmune disorder that affects a few thousand Americans, including children. Common symptoms include:

  • Muscle weakness
  • Trouble swallowing (AKA dysphagia)
  • Difficulty talking
  • Fatigue
  • Red or purple skin rash on a sun-exposed area
  • Calcium deposits underneath your skin (AKA calcinosis)
  • Inflammation around your fingernails
  • Red knuckles

Where it is: Dermatomyositis-related skin rashes most often occur in these 8 parts of the body:

  1. Eyelids
  2. Nose
  3. Cheeks
  4. Back
  5. Upper chest
  6. Elbows
  7. Knees
  8. Knuckles

What it looks like: A purplish or deep red rash.

Is it permanent? There is currently no cure for dermatomyositis, but symptoms can improve with treatment.

Individuals who experience skin rash but not muscle weakness likely suffer from amyopathic dermatomyositis, also called “dermatomyositis sine myositis.”

Psoriasis

Psoriasis is a common autoimmune disorder. The most common symptom of psoriasis is a scaly skin rash. These skin problems may occur anywhere on the body, but psoriasis most commonly affects the elbows, knees, lower back, and scalp.

Psoriasis may be itchy and cause pain. Make sure you do not scratch or itch the psoriasis rash, which can lead to bleeding and infection.

plaque psoriasis rash

Location and appearance vary by type of psoriasis:

There are 7 types of psoriasis:

  1. Plaque psoriasis is the most common type of psoriasis skin rash. Small red bumps form, then get scaly and larger. Up to 90% of psoriasis patients experience this type of rash. 15% of people with plaque psoriasis develop psoriatic arthritis.
  2. Nail psoriasis leads to pits in fingernails and toenails and may result in loss of nails.
  3. Scalp psoriasis forms flakes that look like dandruff and possibly hair loss.
  4. Inverse psoriasis (AKA intertriginous psoriasis) occurs in the skin folds of individuals with psoriasis. Overweight individuals are particularly vulnerable to this form of psoriasis.
  5. Pustular psoriasis causes pus-filled bumps, usually on the feet and hands. These bumps may dry and get brown and scaly.
  6. Guttate psoriasis forms little red spots all over your skin after an infection.
  7. Erythrodermic psoriasis is a rare, life-threatening type of psoriasis. It includes a large patch of red skin, itching, and severe pain. It may be caused by intense sunburn, certain medications, or untreated psoriasis.
guttate psoriasis rash

What autoimmune disease causes an itchy rash? Some autoimmune diseases that may cause an itchy rash are cutaneous lupus, oral lichen planus, and erythrodermic psoriasis.

Eczema

Eczema is an itchy skin condition. Children are at a higher risk of getting eczema than adults. Though eczema often goes away after puberty, it can persist into adulthood.

The 2 basic types of eczema are:

  1. Atopic dermatitis: This is the most common form of eczema. Whether autoimmune or genetic, atopic dermatitis triggers a skin rash when the skin’s natural defenses are weakened. Many people experience atopic dermatitis, asthma, and hay fever together.
  2. Contact dermatitis: This is an allergic reaction (or exposure to a chemical irritant), leading to an itchy skin rash. Contact dermatitis may also result in fluid-filled blisters or scaly patches.

Where it is: Eczema can cause skin problems all over your body, especially on:

  • Hands
  • Feet
  • Arms
  • Legs
  • Elbow
  • Knees
  • Scalp
  • The back of the neck

What it looks like: Red, inflamed skin, often scaly, sometimes cracked and oozing. 

Is it permanent? Eczema cannot be cured, but responds well to treatment.

eczema rash

Hypothyroidism & Myxedema

Severe, untreated hypothyroidism may lead to myxedema, which either means “severely advanced hypothyroidism” or skin problems related to severely advanced hypothyroidism.

Myxedema leads to skin changes, though these may not technically be considered rashes. Myxedema may result in swelling and thickening of your skin.

Where it is: Most commonly on the lower legs, face, and tongue. However, these changes can occur anywhere on your body.

What it looks like: Skin appears dry, waxy, doughy, or swollen.

Is it permanent? No. With immediate treatment, myxedema can be reversed.

rash caused by hypothyroidism-induced myxedema

Severe hypothyroidism may also trigger these 9 symptoms:

  1. Goiter
  2. Fatigue
  3. Brittle hair
  4. Cold sensitivity
  5. Weight gain
  6. Low heart rate
  7. Low blood pressure
  8. Constipation
  9. Depression

Myxedema and severe hypothyroidism require immediate treatment and management. “Myxedema crisis” is when the body no longer tolerates the severe hypothyroidism symptoms. Your body starts to shut down. Myxedema crisis may result in coma, seizures, and death.

Call your doctor or emergency services immediately if you believe you’re having a myxedema crisis.

If you think you may have hypothyroidism, schedule a consult at PrimeHealth in Denver, Colorado. 90% of hypothyroidism cases are autoimmunity-related. Click here to learn how we treat hypothyroidism differently than other doctors.

Celiac Disease

Experts estimate that almost 1% of Americans suffer from celiac disease. Although celiac disease most frequently triggers gastrointestinal distress, it may also trigger an autoimmune rash.

Celiac disease occurs when gluten causes excessive gut inflammation, which may cause the following symptoms:

Celiac disease may result in “dermatitis herpetiformis,” an itchy, blistering rash on your skin. 

Where it is: Usually on the elbows, knees, or buttocks.

What it looks like: Groups of red, hive-like lesions or blisters.

Is it permanent? No. While it can recur after gluten consumption, the rash will go away on its own.

dermatitis herpetiformis rash caused by Celiac disease

Surprisingly, fewer than 10% of individuals with celiac experience both skin problems and the more common digestive symptoms.

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Scleroderma

Also known as systemic sclerosis, scleroderma is a condition in which your immune system mistakenly attacks your own healthy tissues, namely, the skin.

Scleroderma also affects the following:

  • Blood vessels
  • Digestive system
  • Heart
  • Joints
  • Kidneys
  • Bladder
  • Lungs
  • Muscles
scleroderma rash

When you have scleroderma, your skin changes in appearance and feel, due to increased collagen production. It may become shiny and thicker.

Where it is: While it can affect the whole body, scleroderma usually begins with the finger, hands, feet, and face.

What it looks like: Hard or tight skin.

Is it permanent? While there is no cure, for many people symptoms will wax and wane.

Morphea is sometimes synonymous with scleroderma, but morphea is actually a severe type of scleroderma. Morphea specifically refers to oval-shaped areas of thick, red skin.

Risk factors for scleroderma include:

  1. Female gender
  2. African-American or Native American heritage
  3. Exposure to silica dust
  4. Certain chemotherapy drugs

Lichen Planus

Oral lichen planus is an autoimmune disease that may trigger swelling and irritation on your skin.

Where it is: Usually the scalp, nails, genitals, and mucous membranes.

What it looks like: Lichen planus typically causes purple, itchy, flat bumps on the skin. It may also result in lacy-white lesions in the mouth.

Is it permanent? Lichen planus is a chronic condition with no cure currently. Treatment can help alleviate symptoms.

lichen planus example
lichen planus rash on the wrist
Source: study and DermNetNZ

Behçet’s disease

Behçet’s disease is a very rare autoimmune disorder that leads to blood vessel inflammation (vasculitis).

Where it is: Usually in the mouth or genitals.

What it looks like: Round or oval-shaped lesions with red borders.

Is it permanent? The sores usually go away within a few days, but they often recur.

rash caused by Behçet’s disease

Diabetes

Skin conditions affect 50-97% of people with diabetes (both type 1 and type 2). Rashes and skin conditions are sometimes warning signs of prediabetes, or indicators that diabetes a treatment plan needs adjustment.

Diabetes increases risk of many of the conditions we’ve covered as well as others. These conditions may include:

  • Acanthosis: bands of dark, velvety skin
  • Blisters
  • Diabetic dermopathy: reddish brown patches usually on the shins
  • Digital sclerosis: as described above, localized to fingers and hands
  • Folliculitis: small pus-filled bumps on hair follicles
  • Lichen Planus: as described above
  • Necrobiosis lipoidica: raised red shiny patches with a yellow center located on the lower leg
  • Skin tags: small brownish bumps on the skin, often on the neck, eyelids, armpits, or groin

Other common skin conditions include dry skin, bacterial infections and fungal infections.

Where it is: There is a broad range of skin conditions associated with diabetes. Any part of the body can be affected, depending on which conditions present.

What it looks like: Appearance will vary depending individual condition.

Is it permanent? While there is no cure for diabetes, there are many treatment options available to manage symptoms.

Liver Disease

Skin conditions can be a sign of liver disease like cirrhosis or hepatitis C. Rashes caused by liver dysfunction are often the first sign people have that there’s a problem.

Where it is: Anywhere on the body

What it looks like: Liver disease rashes may include:

  • Redness
  • Brown patches
  • Extremely dry skin
  • Severe itching
  • Spider veins

Is it permanent? While there are no cures for cirrhosis of the liver or hepatitis C, there are many treatment options to help manage symptoms.

Autoimmune Blistering Diseases

We’ve been talking a lot about skin rashes. However, some autoimmune conditions can cause skin blistering, too. 

Also known as autoimmune bullous diseases, here are the most common autoimmune diseases that can cause blistering:

  • Epidermolysis bullosa acquisita
  • IgA-mediated bullous dermatoses
  • Ocular cicatricial pemphigoid
  • Bullous pemphigoid
  • Pemphigus

Scalp Itch

Several autoimmune diseases may also cause an itchy scalp. Scalp itch may or may not be caused by sores or lesions on the head. Conditions include:

  • Psoriasis
  • Eczema
  • Lichen planus
  • Lupus
  • Scleroderma
  • Sjögren’s syndrome

Autoimmune Hives

Autoimmune hives are itchy red bumps or welts often caused by allergic reactions. An overactive immune system can also cause them. Autoimmune diseases that may cause hives are:

  • Lupus
  • Sjögren’s
  • Celiac disease
  • Type 1 diabetes
  • Rheumatoid arthritis
  • Vitiligo

Testing for Autoimmune Disease

No single test is designed to test for all autoimmune diseases. If you’re seeking a diagnosis, several blood tests can help your healthcare provider determine if you have an autoimmune disease.

Here are 4 common markers for autoimmune disease:

  1. Antinuclear Antibody (ANA)
  2. Autoantibodies
  3. C-Reactive Protein (CRP)
  4. Erythrocyte Sedimentation Rate (ESR)

These markers may be found through labs like:

  • Bloodwork
  • Urinalysis
  • Skin Biopsy

Treatment Options

How do you treat an autoimmune rash? The best way to treat autoimmune rash (and autoimmune disorders in general) is to identify and treat the underlying cause. There are many possible causes of autoimmunity.

Many people find corticosteroid creams effective for immediate relief during flare-ups. Diet changes may provide longer-term relief.

Because there are multiple potential causes, conventional rheumatologists often say autoimmune disorders are incurable. Then, they focus on treating the symptoms with steroids, vaccines, and immunosuppressive or anti-inflammatory drugs that often trigger adverse side effects and may lead to flare-ups. 

Conventional doctors typically manage symptoms, instead of addressing the underlying cause.

Functional medicine doctors are more equipped to diagnose and treat the underlying cause of autoimmune disease. Functional doctors partner with patients to choose the right nutrition, therapies, and lifestyle changes to optimize their health.

Click here today to schedule a free phone consultation with us. We have successfully treated many patients with autoimmune rashes. Here at PrimeHealth, we empower patients to take an active role in their whole-person health.

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Sources

  1. Grönhagen, C. M., & Nyberg, F. (2014). Cutaneous lupus erythematosus: An update. Indian dermatology online journal, 5(1), 7. 
  2. Talha, B., & Swarnkar, S. A. (2019). Xerostomia. In StatPearls [Internet]. StatPearls Publishing.
  3. Nair, P.A., Badri, T. (2020). Psoriasis. 
  4. Badri, T., Kumar, P., & Oakley, A. M. (2017). Plaque Psoriasis.
  5. Belgrave, D. C., Simpson, A., Buchan, I. E., & Custovic, A. (2015). Atopic dermatitis and respiratory allergy: what is the link. Current dermatology reports, 4(4), 221-227.
  6. Reunala, T. (1998). Dermatitis herpetiformis: coeliac disease of the skin.
  7. Castro, C., & Gourley, M. (2010). Diagnostic testing and interpretation of tests for autoimmunity. Journal of Allergy and Clinical Immunology, 125(2), S238-S247.
  8. De Macedo, G.M.C., Nunes, S. & Barreto, T. (2016) Skin disorders in diabetes mellitus; an epidemiology and physiopathology review. Diabetol Metab Syndr, 8, 63.

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