A characteristic skin symptom in a patient with lupus may include which of the following?

In patients with lupus, the butterfly-shaped rash, also known as a malar rash, is a classic and characteristic skin finding. This rash typically appears across the cheeks and nose, resembling the shape of a butterfly. It is often erythematous and can be a result of photosensitivity, which means that exposure to sunlight can exacerbate the rash. The malar rash is particularly significant in diagnosing systemic lupus erythematosus as it reflects the underlying autoimmune process impacting the skin and connective tissue.

Other options, although they may be related to different conditions or forms of skin involvement, do not specifically correspond to the hallmark symptoms of lupus. For example, thickening of the skin is more commonly associated with conditions like scleroderma, while red, swollen lesions might point towards other dermatological issues or inflammatory conditions. Blisters on the hands can occur in various conditions but are not characteristic of lupus. Thus, the butterfly-shaped rash remains a key feature in the identification and management of lupus.