Lupus is an autoimmune disease, which means the body attacks its own cells and organs—including the skin, joints, heart, lungs, blood, kidneys, and brain—because it can’t differentiate between foreign germs and viruses and healthy cells.

When the body’s immune system turns on itself, the inflammation, pain, and swelling that’s so familiar to lupus sufferers can become a permanent and painful part of everyday life.

However, with the proper diagnosis, treatment plan, and management, lupus sufferers can reduce symptoms and live more comfortably. Here are the 15 primary symptoms of lupus…

1. Skin Rash

Skin rashes are very common in individuals suffering from autoimmune diseases. In the case of lupus, a type of rash known as a malar rash, or a butterfly rash, typically forms on the ears, arms, chest, and face. These rashes are particularly common in the cheeks and across the nose and usually take the shape of a red, blotchy set of butterfly wings. The rash is not really itchy; it is just visually troublesome, and it can be exacerbated by prolonged exposure to heat and/or sunlight.

Because this rash has an autoimmune cause, it will not respond well to topical treatments or other frontline interventions. Your doctor may be unable to find a root cause of the rash upon initial investigation, prompting lupus to be considered later in the diagnostic process. In many cases, the rash is localized to a small area at first, then spreads out to other parts of the body.