OBJECTIVE We sought to compare the prevalence of systemic disease in subacute cutaneous lupus erythematosus (SCLE) with systemic lupus erythematosus (SLE). METHODS Clinical and laboratory features of 14 patients with SCLE were compared with 22 age and sex matched controls with SLE. RESULTS Manifestations other than arthritis and skin disease were present in 11/14 (79%) SCLE cases compared with 19/22 (82%) SLE cases. Severe systemic disease occurred in one-half of patients with SCLE (5/7 men, 1/7 women), and most had the papulosquamous pattern. CONCLUSIONS Systemic manifestations may be as varied in SCLE as in SLE, and severe disease is not unusual. In particular, men with papulosquamous SCLE may be at higher risk for severe extracutaneous disease.