Which of the following is a classic sign of SLE?

A classic sign of systemic lupus erythematosus (SLE) is the presence of a rash over the cheeks and nose, often referred to as the "butterfly rash" or malar rash. This distinctive facial rash arises due to the autoimmune nature of SLE, where the body's immune system attacks its own tissues, causing inflammation and skin lesions. The butterfly rash is particularly characteristic because it typically appears across the cheeks and nose, resembling the shape of a butterfly.

This symptom is associated with photosensitivity, meaning it can be triggered or worsened by exposure to sunlight, which is a common experience for individuals with SLE. Identifying this rash is significant for healthcare providers, as it helps in diagnosing SLE and monitoring the disease progression or flares.

The other options, while they may occur in patients with SLE due to various factors like treatments or coexisting conditions, are not specific classic signs of the disease itself. The butterfly rash stands out as a hallmark feature that is often used in the clinical criteria for diagnosing SLE.