BACKGROUND: Various different mucocutaneous symptoms may affect up to 80 % of 
systemic lupus erythematosus (SLE) patients.
OBJECTIVES: To investigate, various unspecific, but otherwise typical clinical 
symptoms of skin and mucous membranes that arise in SLE patients other than 
those defined as SLE criteria such as butterfly rash, chronic cutaneous lupus 
erythematosus, oral ulcers, and increased photosensitivity.
MATERIALS AND METHODS: Extensive search of peer-reviewed scientific articles was 
performed, medical histories of several SLE patients seen in our department were 
analyzed, and the rare disease courses in three SLE patients are presented.
RESULTS: Here we present a variety of unspecific but typical mucocutaneous 
manifestations in SLE patients: periungual erythema, periungual telangiectasia 
and periungual splinter hemorrhage, papules on the dorsum of the hands, scaling 
erythema, sometimes associated with necrosis, especially of the ears, along with 
complement deficiency, and the bizarre necroses of antiphospholipid syndrome. 
Furthermore, we show the typical clinico-histological features of neutrophilic 
urticarial dermatosis, as well as those of bullous SLE and finally a severe 
course of bacterial sepsis with Neisseria flavescens/macacae.
CONCLUSIONS: Here we show several unspecific but rather typical mucocutaneous 
symptoms in lupus patients that are indicative of SLE and thus may lead to an 
early diagnosis. Also, life-threatening bacterial sepsis may occur with 
microorganisms that are commonly considered "apathogenic", such as Neisseria 
flavescens/macacae, which exclusively affect immunosuppressed patients.