A client arrives for initial evaluation following a diagnosis of systemic lupus erythematosus (SLE). The nurse understands that which of the following is a classic cutaneous manifestation of SLE?

A. Brittle fingernails: Brittle nails may result from aging, nutritional deficiencies, or other chronic conditions, but they are not a hallmark feature of systemic lupus erythematosus. Nail changes in SLE can occur, such as periungual erythema or splinter hemorrhages, but brittleness alone is nonspecific. B. Pallor of the face: Facial pallor is typically associated with anemia or circulatory issues rather than SLE-specific dermatologic manifestations. While anemia can occur in SLE, pallor is not considered a classic cutaneous sign of the disease. C. Ulcers of the feet: Oral or nasal ulcers are common in SLE, but ulcers on the feet are less characteristic. Foot ulcers may occur in cases of vasculitis or secondary complications, but they are not a defining feature of SLE. D. Butterfly rash on face: The malar or “butterfly” rash is a classic cutaneous manifestation of SLE, appearing as erythema over the cheeks and bridge of the nose, sparing the nasolabial folds. This photosensitive rash often worsens with sun exposure and is considered a key diagnostic feature in combination with other systemic signs of lupus.