Family Nurse Practitioner Exam

Which symptom indicates a patient may have systemic lupus erythematosus apart from positive ANA?

1. Weight loss

2. Joint pain

3. Skin rash

4. Fatigue

The correct answer is: Skin rash

A skin rash is indeed a prominent symptom associated with systemic lupus erythematosus (SLE), particularly the characteristic "butterfly rash" that appears across the cheeks and nose. This rash is one of the hallmark features used in the clinical diagnosis of SLE. Other skin manifestations can also occur in lupus, including discoid lesions and other types of rashes, which further support the diagnosis in the context of a positive antinuclear antibody (ANA) test. In addition to the specificity of the skin rash for lupus, the presence of such cutaneous symptoms can often indicate active disease and contribute to the classification criteria for SLE. Thus, recognizing a skin rash is crucial for clinicians when evaluating a patient for SLE, alongside the positive ANA test and other systemic symptoms.