How To Determine If Your Hives Rash Is Lupus, Urticarial Vasculitis or Ordinary Hives?
Most hives have nothing to do with lupus. However, lupus can cause a hives-like rash called urticarial vasculitis, which behaves differently from ordinary urticaria and needs different care.
How Lupus Hives Differ
- Welts last longer than 24 hours, often 1 to 3 days
- They burn or sting more than they itch
- They leave bruising or brown discoloration
- They come with joint pain, fatigue or fever
Tests Doctors May Order
A skin biopsy can show inflammation of small blood vessels. Blood tests may include ANA, complement levels (C3, C4) and inflammation markers. See autoimmune hives.
Treatment
Urticarial vasculitis does not respond reliably to antihistamines alone. A rheumatologist or dermatologist may use medicines such as hydroxychloroquine, colchicine or other immune-modulating drugs. Learn about ordinary chronic hives.
When to Call 911
Do not wait it out: hives with shortness of breath, noisy breathing, a hoarse voice, swelling of the tongue or throat, dizziness, a racing pulse, or repeated vomiting are signs of a possible severe allergic reaction (anaphylaxis). Call 911 immediately.
When to See a Doctor
See a doctor if your symptoms last more than a few days, keep coming back, cover large areas, or interfere with sleep or daily life. At the Hives Treatment Center in San Francisco, Dr. Tiffany Young sees patients with lupus-related hives through online and in-person visits.
Related Reading
You may also find these guides helpful: causes of hives and hives symptoms.
Frequently Asked Questions About Lupus Hives
Can lupus cause hives?
Yes, but it is uncommon. Most chronic hives are not lupus.
Do lupus hives leave marks?
Often yes, especially bruising.
Who should I see?
A dermatologist or rheumatologist.
Get Relief for Your Hives
Hives that last more than a day and leave marks should be checked. Visit our hives treatment page to see the latest treatment options for your outbreak.
This information is for educational purposes only and is not a substitute for professional medical advice, diagnosis or treatment. If you think you are having a medical emergency, call 911.
