Lupus erythematosus is called lupus for short, because the main manifestation of this disease is butterfly-shaped erythema on the cheeks of the face, or discoid erythema on other parts of the skin, as if bitten by a wolf. There is also a distinction between discoid lupus erythematosus (DLE), which is confined to the skin, and systemic lupus (SLE), which involves multiple organs throughout the body. Drug-induced lupus (DIL) is a lupus-like disease caused by taking certain drugs. Drug-induced lupus is not true lupus, but rather lupus-like skin lesions and systemic immune reactions that occur only after taking certain drugs, and can be clinically indistinguishable from primary SLE. Drug-related lupus can be detected as early as possible. The following is a brief introduction to the clinical manifestations of lupus and the common drugs that can trigger lupus. Li Xuemei, Department of Rheumatology and Immunology, Xuanwu Hospital, Capital Medical University 1. Clinical manifestations of lupus erythematosus 1. However, fever caused by infectious factors should be excluded.2. Skin and mucous membranes: bright red rash appears on the bridge of the nose and cheeks of both cheeks, the scope is limited to both sides of the cheeks and the bridge of the nose, the edges are clear, the rash looks like a butterfly, commonly known as butterfly-shaped erythema, this rash also has photoallergic manifestations, the color of the rash deepens after outdoor sun exposure, edema increases, touching the edges of the erythema with hands, there is a sense of tenderness, butterfly-shaped erythema is Butterfly erythema is a characteristic change of lupus. Skin lesions of lupus also include alopecia, palmar and perineal erythema, discoid erythema, erythema nodosum, lipofuscinosis, reticular cyanosis and Raynaud’s phenomenon. Mucosal damage includes oral ulcers. 3. Joints and muscles: Very common, with 80% of cases showing symmetrical multi-joint pain and swelling, usually without bone destruction. 50% of drug-related lupus may show myalgia and muscle weakness, and a few may have increased muscle enzyme profiles. 4. Kidney damage: Also known as lupus nephritis (LN), manifesting as proteinuria, hematuria, tubuluria and even renal failure. 50% to 70% of Clinical renal involvement occurs during the course of SLE, and renal biopsy shows pathological changes in almost all SLE. However, kidney damage is relatively rare in drug-related lupus.5. Neurological damage: Also known as neuropsychiatric lupus. In mild cases, only migraine, personality changes, memory loss or mild cognitive impairment are observed; in severe cases, cerebrovascular accidents, coma, and persistent epilepsy may be manifested.6. Hematologic manifestations: anemia and/or leukopenia and/or thrombocytopenia are often seen.7. Pulmonary manifestations: pleurisy is often seen. Exudative plasma cavity effusion in young patients (especially women) should be noted as a possibility of lupus in addition to tuberculosis. The cough symptoms of lupus lung damage are relatively mild, the sputum volume is low, and yellow sticky sputum is usually not produced. Interstitial lung lesions caused by lupus are manifested by shortness of breath after activity, dry cough, hypoxemia, and pulmonary function tests often show decreased diffusion function. Hemoptysis may occur in a few critically ill patients, those with pulmonary hypertension, or those with vasculitis involving the bronchial mucosa.8. Cardiac manifestations: pericarditis often occurs, manifested as pericardial effusion, but pericardial tamponade is rare. In most cases, myocarditis and arrhythmia can be present in lupus, but in severe SLE, cardiac insufficiency can be present, which is a poor prognosis. It is more common and can be accompanied by protein-losing enteritis and cause hypoproteinemia.10. Immunological abnormalities: It is difficult to distinguish SLE from drug-related lupus in clinical manifestations, but there are some differences in immunological examination. Although both will be positive for ANA (antinuclear antibody). However, anti-ds-DNA antibodies and anti-Sm antibodies, which are specific to SLE, are rarely positive in drug-resistant lupus. More than 80 drugs have been found to induce pharmacologic lupus, and some of the more relevant drugs include: procainamide, sulfadiazine, isoniazid, chlorpromazine, carbamazepine, phenytoin sodium, valproate, amiodarone, quinidine, propylthiouracil, methomazole, zallust, hydrazidiazine, hydrochlorothiazide, methyldopa, lenopril, minocycline penicillamine, salazosulfapyridine, etc. Statin lipid modulators (fluvastatin, lovastatin and simvastatin) have been reported. It is worth noting that some drugs are often present not as single drugs, but in combination formulations, for example, booster sulfadiazine tablets contain sulfadiazine, and compounded reserpine tablets contain hydrazine, so you must pay attention to the composition of the drug when applying it. As new drugs continue to appear, the number of drugs that trigger drug-induced lupus will further increase. Patients with drug lupus have a clear history of drug use, and if they are diagnosed early and the drugs that trigger lupus are stopped in time, their clinical symptoms can be relieved quickly and they can be completely cured. However, re-use of disease-causing drugs should be avoided to avoid causing lupus recurrence. For patients who are themselves suffering from systemic lupus erythematosus, the use of lupus-inducing drugs should be avoided as much as possible. In general, these drugs can still be taken safely, and the chance of drug-induced lupus is very small. Once there are manifestations of lupus-like symptoms, patients should go to regular hospitals in time to ensure the safety of medication.