What Does an Autoimmune Rash Looks Like? Conditions & Other Symptoms (2024)

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. When the body mistakenly targets skin cells, you may develop an uncomfortable or concerning rash.

About 50 million Americans suffer from autoimmune diseases like rheumatoid arthritis or Hashimoto’s thyroiditis. Between 5-8% of Americans are likely to experience an autoimmune skin disorder at some point. Women are especially at risk, thanks to differences in genetic makeup.

The most common autoimmune diseases that may cause rashes on your skin include:

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

Symptoms of an Autoimmune Rash

Some of the symptoms most common to autoimmune rashes are:

• Inflamed, red skin: Like with any rash, your skin may turn red or otherwise discolored (some autoimmune rashes are more purple or brown in color) and feel warmer than the surrounding skin.
• Itch: Some, though not all, rashes associated with autoimmune disease cause an urge to itch.
• Pain or discomfort: Some rashes may hurt or feel tender when touched, while others may cause persistent discomfort.
• Varied shapes, sizes, and rash patterns: If you have an autoimmune rash, you may observe its size or shape change. Rash patterns vary and may also morph over time.

What Causes an Autoimmune Rash?

Various types of autoimmune activity may cause any number of rashes. There are several factors that may lead to autoimmune disease and dysregulated immune responses, such as:

• Genetics: Like many conditions, a genetic predisposition to autoimmune disease increases the likelihood you will develop autoimmunity. The more blood relatives you have who suffer from these diseases, the higher your chances will be.
• Hormones: Your hormonal makeup impacts the way your immune system functions. Major changes to hormone levels, like those that occur during menopause and pregnancy, can trigger autoimmunity and related skin rashes. That’s one reason females are more likely than males to have autoimmune issues.
• Mental health: Particularly if you already have an autoimmune condition, anxiety, stress, or other mental health concerns may trigger flare-ups. Your gut and brain are closely connected, so significant changes to your mental health or nervous system function play a part in autoimmune responses.
• Environmental triggers: If you’re sensitive to certain chemicals in everyday items such as detergent, body wash, or makeup, these chemicals may increase your likelihood of developing an autoimmune rash.

Let’s take a look at the specific autoimmune conditions that are most likely to cause a rash and how these rashes may present.

Psoriasis

Psoriasis is the most common autoimmune skin rash. 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.

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.

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.

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

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

Lupus

Among other symptoms, two-thirds of lupus patients will develop a skin condition. Skin disease in lupus may present as rashes, sores, lesions, or cherry angiomas — a bright red, raised patch of skin.

Up to 70% of lupus cases are worsened by sun exposure or extended time under fluorescent lights. Many lupus-related rashes will appear in sun-exposed areas of the skin, often a butterfly-shaped rash across the nose and cheeks.

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.

Sjögren’s Syndrome

Individuals with Sjögren’s may develop a skin rash. Sjögren’s syndrome is an autoimmune disease that most frequently causes dry eyes and dry mouth. Mainly affecting women over 40, Sjögren’s syndrome affects up to 3 million Americans.

Sjögren’s syndrome may lead to the following skin problems:

• 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)

See Also

What You Should Know About the Gluten Rash | Best in Gluten Free | SchärDermatitis Herpetiformis: Celiac Disease, Symptoms & TreatmentSkin Conditions That Might Be a Sign of a Gluten AllergyFacial Presentations Can Indicate Gut Health | Dr. Margaret Litchy-Miller

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, if Sjögren’s 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 juveniles. Common symptoms include:

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

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

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

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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.

Skin changes related to myxedema are most common:

• On your lower legs
• On the face
• On your tongue

However, these changes can occur anywhere on your body.

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.

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:

• Anemia
• Fatigue
• Gas
• Stomach growling
• Bloating
• Constipation
• Diarrhea
• Depression
• Skin rash

Celiac disease may result in “dermatitis herpetiformis”, an itchy, blistering rash on your skin. This usually appears on the elbows, knees, or buttocks.

Surprisingly, fewer than 10% of individuals with celiac experience both skin problems and the more common digestive symptoms. More often than not, patients have only one or the other.

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
• Lungs
• Muscles

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

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 sex
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, scalp, nails, genitals, and mucous membranes.

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

Behçet’s disease

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

Behçet’s disease symptoms include:

• Skin rashes/lesions
• Mouth sores
• Eye inflammation
• Genital sores

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, the most common autoimmune diseases that can cause blistering are:

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

When to Call Your Doctor

It’s always advisable to keep an eye on a new rash. Here are some signs that you should see a healthcare professional:

• Sudden onset of a new rash
• Fever
• Pain
• Blisters
• Swelling
• Discharge
• Bruising
• A bad smell
• The rash area is spreading

FAQs

What to Do About Autoimmune Rashes

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. For immediate relief, over-the-counter corticosteroid creams may help with discomfort.

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

Integrative medicine and functional medicine doctors are more equipped to diagnose and treat the underlying cause of autoimmune disease. This can be achieved through a combination of medication, dietary coaching, and lifestyle changes.

Schedule a free phone consultation with PrimeHealth if you live in Colorado and are experiencing an unexpected rash. 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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