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Dr. Chrysoula I. Liakou MD, PhD
- Treated online: Assessment online. A doctor can judge whether your symptoms could be lupus, arrange the first tests and help with flares and medicine questions; diagnosis and treatment are led by a rheumatologist.
- What it is: a long-term autoimmune condition in which the immune system attacks healthy tissue, most often the joints, skin and kidneys. It is not contagious.
- Who gets it: about 10 times more women than men, most often between the ages of 15 and 45, and more often people of African, Caribbean or Asian descent.
- Main symptoms: joint and muscle pain, extreme tiredness that rest does not ease, and rashes after sun exposure, often over the nose and cheeks.
- Emergency: call 112 or go to an emergency department for chest pain, difficulty breathing, a seizure, sudden confusion, or signs of a stroke.
Do not book a video appointment if you have chest pain or difficulty breathing, a seizure, sudden confusion or a sudden severe headache, weakness or drooping of the face, arm or leg or slurred speech, or a calf that is swollen, hot and painful. Call 112 or go to an emergency department.
Can an online doctor help with lupus?
Lupus cannot be diagnosed or treated online alone: the diagnosis needs an examination, blood and urine tests and usually a rheumatologist, who also leads treatment. What a doctor by video can do is go through symptoms that could be lupus, arrange the first blood and urine tests and a referral, look at a rash on camera and, if you already have lupus, help you recognise a flare, check your medicines and tell you when you need to be seen urgently.
How an online consultation helps with lupus
- Could it be lupus?: Joint pain, tiredness and rashes have many causes, and the pattern of your symptoms decides which tests make sense.
- The first tests arranged: Blood tests for antibodies such as ANA, a blood count and a urine test, and a referral when the results point to lupus.
- Flares recognised early: Which changes mean a flare to manage at home, and which mean your kidneys, heart or lungs need checking.
- Medicines and daily life: Hydroxychloroquine, steroids and sun protection, pregnancy plans, and work.
What the doctor checks in an online lupus assessment
The doctor asks about the warning signs first, then about the symptoms that point towards or away from lupus. The doctor asks about:
- Warning signs: chest pain, breathlessness, a seizure, confusion, a swollen calf, or swollen legs with foamy urine.
- Joints and muscles: which joints hurt or swell, and how stiff they are in the morning.
- Skin and hair: rashes after sun exposure, mouth or nose ulcers, and hair loss, which you can show on camera.
- The whole body: tiredness, fevers, weight loss, swollen glands, and fingers or toes that change colour in the cold.
- Medicines: some blood pressure, seizure and antibiotic medicines can cause lupus-like symptoms.
- Your health: pregnancy or plans for it, earlier miscarriages or blood clots, and autoimmune conditions in your family.
Before the call, take photos of any rash when it is at its worst, and have recent blood test results to hand.
What is lupus, and who gets it?
Lupus, or systemic lupus erythematosus (SLE), is a long-term autoimmune condition: the immune system attacks healthy parts of the body, causing inflammation in the joints and skin and sometimes in the kidneys, heart, lungs, blood and brain. It is not contagious. There is no cure yet, but modern treatment keeps it under control for most people.
Lupus is about 10 times more common in women than in men, and usually starts between the ages of 15 and 45. It is more common, and can be more severe, in people of African, Caribbean and Asian descent.
What causes lupus, and is it hereditary?
The exact cause is not known. Genes and the environment probably act together, and possible triggers include viral infections, sunlight, certain medicines, puberty, childbirth and the menopause. Genes play a part, but there is no genetic test for lupus.
Lupus caused by medicines
Some blood pressure medicines, seizure medicines and antibiotics can cause lupus-like symptoms. Most people improve after the medicine is stopped, which should only be done on a doctor’s advice.
What are the symptoms of lupus?
The three main symptoms are joint and muscle pain, extreme tiredness that does not improve with rest, and rashes, often after sun exposure. Everyone with lupus has joint pain at some point, and almost 9 in 10 people with lupus report tiredness. Symptoms can start suddenly or slowly.
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| Symptom | What you may notice |
|---|---|
| Joint and muscle pain | Pain, stiffness and sometimes swelling in several joints |
| Tiredness | Extreme tiredness that rest does not ease, and brain fog |
| Rash | A butterfly-shaped rash across the cheeks and nose, in about half of people, or rashes that get worse in sunlight |
| Ulcers | Sores in the mouth or nose |
| Fever and weight loss | A high temperature and weight loss with no other cause |
| Hair loss | Thinning or falling hair |
| Raynaud’s | Fingers or toes turning white or blue in the cold or with stress |
| Chest pain | Pain when you breathe in deeply, from inflammation of the lining of the lungs or heart |
| Other symptoms | Headaches, swollen glands, depression and anxiety, and sensitivity to light |
How do people with lupus feel? Flares and remission
Lupus usually comes and goes. During a flare, symptoms get worse or new ones appear, for weeks or longer, then settle into remission, when they are mild or disappear for a while. Some people have symptoms all the time. Sunlight and infections can bring symptoms on, but often there is no clear trigger.
Is lupus a serious disease?
It can be. Lupus ranges from mild, affecting mainly the joints and skin with tiredness, to severe, with inflammation that damages the kidneys, heart, lungs or brain and can be life-threatening. Kidney failure is one of the leading causes of death in people with lupus, which is why regular urine tests matter. With treatment, most people with lupus can now expect to live a normal lifespan.
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| Part of the body | What can happen | How it is checked |
|---|---|---|
| Kidneys | Inflammation (lupus nephritis), which can lead to kidney failure | Regular urine and blood tests |
| Heart and blood vessels | Inflammation of the heart or its lining, and a higher risk of heart attack | Blood pressure, cholesterol and heart checks |
| Lungs | Inflammation of the lining of the chest, which makes breathing painful, and pneumonia | Examination and a chest X-ray |
| Blood | Anaemia, and a higher risk of bleeding or of blood clots | Blood counts and clotting tests |
| Brain and nerves | Headaches, memory problems, seizures or strokes | Examination and scans |
| Pregnancy | A higher risk of miscarriage, high blood pressure and premature birth | Planning with your specialist before trying to conceive |
People with lupus also have a higher risk of infections, from the disease itself and from the medicines that treat it.
How is lupus diagnosed?
There is no single test. A rheumatologist usually makes the diagnosis from your symptoms, an examination and the test results, and it can take time, because lupus looks like many other conditions. The usual tests are:
- an antinuclear antibody (ANA) test: nearly everyone with lupus has a positive result, but so do many people without it, so a positive ANA on its own does not mean lupus
- tests for antibodies to double-stranded DNA and other antibodies, and complement levels (C3 and C4)
- a full blood count, inflammation markers, and kidney and liver tests
- a urine test, to look for protein or blood coming from the kidneys
- sometimes a chest X-ray or scans of the heart, kidneys or other organs
Early diagnosis matters, because prompt treatment aims to bring lupus under control before organs are damaged. Once lupus is diagnosed, regular blood and urine tests continue even when you feel well, to catch kidney inflammation early.
What might the doctor recommend if you could have lupus?
What happens next depends on your symptoms, your test results and whether you already have a diagnosis. This is the framework the doctors use:
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| What you have | Likely first step | Suitable for online care? | When in-person care is needed |
|---|---|---|---|
| Joint pain, tiredness and a rash after sun, without a diagnosis | Blood and urine tests, including ANA | Yes, to assess | For the tests, and a rheumatologist if they point to lupus |
| A positive ANA test with few or no symptoms | A review of your symptoms, and further tests if needed | Yes, to assess | A rheumatologist if your symptoms or other results fit lupus |
| Known lupus with a mild flare of joint pain or rash | Rest, sun protection and pain relief, and contact with your specialist team | Partly | If the flare does not settle, or new symptoms start |
| Known lupus with a fever, on steroids or immunosuppressants | Assessment for an infection | Yes, to assess | Prompt examination in person if you are unwell |
| Swollen legs, foamy urine or blood in the urine | Urgent kidney tests | No | Prompt assessment in person |
| Chest pain, breathlessness, a seizure, confusion or a swollen, painful calf | Emergency assessment | No | Call 112 or go to an emergency department |
Wondering whether your symptoms could be lupus? A doctor can tell you in one consultation which tests make sense.
See available times →How is lupus treated?
Lupus has no cure, but treatment controls the symptoms and protects the organs. A rheumatologist leads it, often with other specialists, and the aim is to bring the disease into remission with as little steroid as possible.
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| Treatment | What it is used for |
|---|---|
| Hydroxychloroquine | Recommended for nearly everyone with lupus unless it is unsuitable; eases tiredness, skin and joint problems; needs regular eye checks |
| Anti-inflammatories such as ibuprofen | Joint and muscle pain, for short spells, if they suit you |
| Steroids | Flares, kidney inflammation and rashes, as tablets, injections or creams; reduced to a low dose and stopped when possible |
| Immunosuppressants such as methotrexate, azathioprine or mycophenolate | Lupus that hydroxychloroquine does not control, or when steroids cannot be reduced |
| Biological medicines such as belimumab or anifrolumab | Active lupus that other treatments have not controlled |
What you can do yourself
- Protect your skin from the sun: sunscreen of at least factor 50 and a hat whenever you are outdoors.
- Pace yourself, and stay active even on bad days.
- Do not smoke: smoking makes lupus worse.
- Eat a balanced diet that includes calcium and vitamin D.
- Keep up with vaccinations, including flu, COVID-19 and pneumococcal vaccines, and ask about the shingles vaccine.
- Tell your employer, who may be able to adjust your working pattern, and ask family and friends for support.
Prescription treatment
A prescription is never issued without a consultation. Lupus treatment is started and adjusted by your specialist team. For lupus that is already diagnosed, the doctor may continue an established medicine such as hydroxychloroquine when it is right for you, or prescribe an anti-inflammatory or a high-factor sunscreen for a flare of joint pain or skin symptoms, and tells you when your specialist needs to see you. Steroid courses, immunosuppressants and biological medicines are decided by your specialist. If the doctor prescribes, use the prescription at a pharmacy near you.
What does not help
Stopping hydroxychloroquine or steroids suddenly without advice. Sunbathing and sunbeds. Treating a positive ANA test alone as a diagnosis. Smoking.
Special situations
Pregnancy
Lupus raises the risk of miscarriage, high blood pressure in pregnancy and premature birth. See your doctor before trying to conceive, to discuss the risks and review your medicines; doctors often advise waiting until lupus has been well controlled.
Sun and travel
Strong summer sun in southern Europe can bring on rashes and other symptoms, so plan shade, sunscreen of factor 50 or more and a hat, and take enough of your medicines for the whole trip. Infections matter more if you take immunosuppressants. Other holiday problems are covered on the travel illnesses page.
Living with tiredness and pain
Pacing, relaxation techniques and support from family, friends and health professionals help. Depression and anxiety are common with lupus and can be treated too.
Children
Mobi Doctor consultations are for adults aged 18 and over. A child who is unwell needs a paediatrician or a local doctor in person, and emergency signs in a child mean 112.
When lupus is assessed online, and when you need in-person care
Assessed online: symptoms that could be lupus, the first blood and urine tests, rashes on camera, flares in diagnosed lupus, medicine questions and side effects, sun protection, pregnancy plans and work.
In-person care: diagnosis by a rheumatologist, examinations, regular blood and urine tests, eye checks, starting or changing immunosuppressants and biological medicines, and any warning sign.
When to get in-person care
Call 112 or go to an emergency department now for:
- chest pain, or difficulty breathing
- a seizure, sudden confusion, or a sudden severe headache
- weakness or drooping of the face, arm or leg, or slurred speech
- a calf that is swollen, hot and painful
- a hot, swollen joint with a fever
Get medical advice the same day for:
- a fever, especially if you take steroids, immunosuppressants or biological medicines
- swollen legs or ankles, foamy urine, or blood in your urine
- pain when you breathe in deeply
- unusual bruising or bleeding
How Mobi Doctor works
- Book a time that suits you: daily 7am–11pm CEST. You can see a doctor over video, usually within 15 minutes. No subscription, and the exact price is shown before you pay.
- Speak to a licensed doctor about your symptoms: describe your joints, tiredness and any rash, show photos of the rash, and have any test results to hand.
- Leave with a plan: what to do, what to take and for how long, and which signs mean you should be seen in person. If the doctor prescribes, use the prescription at a pharmacy near you.
No sign-up needed
Not sure it’s lupus? Tick every symptom you have to see each condition page that mentions it. It finds the right page, not a diagnosis: a doctor gives you that on a video call.
Tap the body — an area or a point — to browse symptoms anywhere
Similar symptoms, different condition? Rheumatoid arthritis can start the same way. Compare them, or look up any other symptom in the full symptom checker.
Frequently asked questions about lupus
What is lupus?
Lupus, or systemic lupus erythematosus, is a long-term autoimmune condition in which the immune system attacks healthy tissue, causing inflammation in the joints and skin and sometimes in the kidneys, heart, lungs, blood and brain.
What are the main signs of lupus?
The main signs of lupus are joint and muscle pain, extreme tiredness that rest does not ease, and rashes after sun exposure, such as a butterfly-shaped rash over the cheeks and nose. Mouth ulcers, fevers, hair loss, chest pain on breathing in and fingers that change colour in the cold are other signs.
How do people with lupus feel?
Most people with lupus feel tired and achy, with joint pain that comes and goes. Symptoms flare for weeks or longer and then settle, and some people have symptoms all the time.
Is lupus a serious disease?
It can be. Mild lupus affects mainly the joints and skin, but lupus can also inflame the kidneys, heart, lungs or brain, which can be life-threatening. Regular checks and treatment keep it under control for most people.
Can lupus kill you?
Severe lupus can be life-threatening, and kidney failure is one of the leading causes of death in people with lupus. With modern treatment, most people can expect to live a normal lifespan.
What is the outlook with lupus?
Much better than it was: with modern treatment, most people with lupus live a normal span, working, having children and staying active. The outlook depends on which organs are involved; kidney, heart or brain involvement needs closer specialist care, and the main long-term risks are kidney damage, heart disease and infections, which regular checks aim to catch early. Lupus tends to flare and settle over the years, and many people have long quiet spells.
What causes lupus?
The exact cause of lupus is not known. Genes and the environment probably act together, and triggers include viral infections, sunlight, some medicines, puberty, childbirth and the menopause.
Is lupus hereditary?
Genes play a part in lupus, alongside triggers in the environment such as viral infections, sunlight and some medicines, but it is not simply passed from parent to child: most children of someone with lupus never develop it, and there is no genetic test for it. Having a close relative with lupus or another autoimmune condition raises the risk a little, which is worth mentioning to the doctor.
Is lupus contagious?
No. Lupus is an autoimmune condition, not an infection, so you cannot catch it from someone else or pass it on through contact, kissing, sex or sharing food. The immune system of the person with lupus attacks their own tissues, and the triggers that set it off, such as sunlight, viral infections or some medicines, do not make the condition itself contagious.
How is lupus diagnosed?
From your symptoms, an examination, and blood and urine tests, usually by a rheumatologist. Nearly everyone with lupus has a positive ANA test, but many people without lupus do too, so other antibody, blood and urine tests are needed.
Is it lupus or something else?
Many conditions mimic lupus, which is why diagnosis takes a specialist: rheumatoid arthritis causes similar joint pain but rarely rashes or kidney problems; fibromyalgia causes widespread pain and tiredness with normal blood tests; rosacea causes a facial redness that can be mistaken for the butterfly rash but usually comes with spots and flushing; and an underactive thyroid, anaemia or a viral infection can cause the tiredness and aches. A positive ANA blood test alone does not mean lupus, since many healthy people have one.
Can lupus be cured?
Not yet, but treatment controls lupus for most people. Hydroxychloroquine is recommended for nearly everyone with lupus, because it reduces flares and protects the organs; steroids calm a flare quickly; and immunosuppressants or biological medicines are added when the kidneys or other organs are involved or when flares keep coming. The aim is remission or the lowest possible disease activity, with as little steroid as possible.
What can I do myself to manage lupus?
Protect yourself from the sun every day with high-factor sunscreen, a hat and long sleeves, because sunlight triggers lupus flares; take hydroxychloroquine and other medicines as prescribed even when you feel well; pace yourself and rest before you are exhausted, since tiredness is the symptom most people struggle with; keep active with gentle exercise; do not smoke, which makes lupus worse; keep vaccinations up to date; and learn your flare warning signs so treatment can be adjusted early.
Who gets lupus?
Lupus affects women about 10 times more often than men, most often between the ages of 15 and 45. It is more common, and can be more severe, in people of African, Caribbean and Asian descent.
Can lupus flares be prevented?
Lupus itself cannot be prevented, but flares can be made less likely. Protect your skin from the sun with sunscreen of at least factor 50 and a hat whenever you are outdoors, because sunlight is a trigger; take your lupus medicines as prescribed; do not smoke, which makes lupus worse; keep vaccinations up to date; and learn your own flare warning signs so treatment can be adjusted early. Other triggers include viral infections, certain medicines, puberty, childbirth and the menopause.
Can an online doctor diagnose lupus?
No. A doctor by video can judge whether your symptoms could be lupus, arrange the first blood and urine tests and refer you, but the diagnosis is made in person, usually by a rheumatologist.
- Lupus, NHS, National Health Service (UK), reviewed 19 July 2023.
- Lupus: symptoms and causes, Mayo Clinic (US), 12 December 2025.
- Systemic lupus erythematosus, MedlinePlus, US National Library of Medicine, reviewed 28 January 2025.
- EULAR recommendations for the management of systemic lupus erythematosus: 2023 update, Fanouriakis A, et al. Annals of the Rheumatic Diseases, 2024.
- What is lupus?, LUPUS UK, updated December 2025.
This page is for information only and is not a substitute for a medical consultation. Guideline links are provided for transparency; treatment decisions are made with your doctor.
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