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Objectives Up to 75% of patients with systemic lupus erythematosus develop cutaneous manifestations, which range from mild rashes to severe inflammatory lesions. The Barts Health LupusUK Centre of Excellence operates a dedicated lupus dermatology clinic, providing specialist assessment and managementObjective To retrospectively evaluate the demographics, cutaneous manifestations, systemic involvement, and treatment approaches among patients with CLE referred to the Barts Health lupus dermatology clinic.Methods A retrospective review was conducted using medical records from 150 patients seen between July 2024 and July 2025 in the Lupus-Dermatology Clinic at the Barts Health Lupus Centre (Mile End Hospital). Data collected included demographics (sex, age, ethnicity), lupus subtype, cutaneous features, systemic organ involvement, and treatments.Results All referrals were internal, primarily from rheumatology and renal clinics. The cohort was predominantly female (n=133, 90%), aged 18–50 years (76.7%). Ethnic distribution included Asian (43.3%), White (29.3%), Black (24.7%), and Mixed ethnicity (1.3%).The main referral reasons were alopecia (26.7%), generalized discoid lupus (25.3%), chilblain lupus (9.3%), and lupus profundus (8.7%). Generalized discoid lupus was most frequent among Black patients (41.7%), while lupus profundus (13.8%) and chilblain lupus (12.3%) were more common in Asian patients. White patients most often presented with photosensitivity or malar rash (45.8%), occasionally associated with livedo reticularis or vasculitis (9.1%).A subset of patients (n=32, 21%) had skin-limited lupus. Among those with systemic involvement, joint (52%) and renal (43%) manifestations predominated, occurring more frequently in Asian and Black patients. At referral, most were already on hydroxychloroquine (69%), with over half (56%) receiving additional systemic immunosuppressants. In-clinic, topical corticosteroids (39%) and tacrolimus (31%) were the most frequently prescribed agents, while acitretin (4%) and dapsone (1%) were reserved for refractory disease.For skin-limited lupus, systemic therapy was initiated in selected cases, including prednisolone (28%), azathioprine (16%), methotrexate (9%), and mycophenolate mofetil (9%). Rituximab was used in 7% of severe or treatment-resistant patients.Conclusions Alopecia, generalized discoid lupus, chilblain lupus, and lupus profundus were the most frequent dermatologic presentations across all ethnicities. Combination topical and systemic approaches were commonly required. Specialist dermatology input within multidisciplinary lupus centers enhances diagnostic accuracy and optimizes skin disease management.