Systemic lupus erythematosus is a systemic disease, mainly caused by antigen-antibody immune reactions to form vasculitis, resulting in tissue damage in different areas and producing corresponding clinical manifestations, because all organs in the body have blood supply, so all areas with blood vessels may be involved and produce different clinical manifestations. The incidence of skin damage in SLE is about 60-80%, typically seen as butterfly-shaped erythema on the cheek, but also on the face, forehead, neck, chest and back, palms or soles of the feet, and fingertips in the form of painless erythema and macules with local scaling. In addition to various rashes, the lesions may also manifest as diffuse alopecia, Raynaud’s phenomenon, etc. Therefore, about 20% to 40% of patients can be diagnosed with lupus erythematosus even though there is no erythema during the course of the disease, but the other clinical symptoms and immunological tests are consistent. In particular, some patients with renal damage as the first manifestation often have less or later manifestation of skin damage than visceral damage, but the disease may be more severe. Erythema of the skin should not be equated with lupus, as other rheumatologic and dermatologic diseases such as dermatomyositis and erythema nodosum can also show erythema, and sometimes there are few patients with lupus without erythema, so the diagnosis of SLE should not be easily denied and delayed because of the absence of erythema.