Twelve of 54 patients with systemic lupus erythematosus (SLE) had nonpurpuric, chronic urticaria-like lesions. Skin biopsy of the lesions was performed in 11 cases and 9 showed necrotizing vasculitis. The 54 patients, in general, had severe disease; laboratory and clinical data suggested a positive relationship between the urticaria-like lesions and disease severity. There was no consistent relationship between the course of the urticaria-like lesions and the serologic findings and clinical activity of the SLE. The frequency and importance of urticaria-like lesions in SLE deserve further study.