Yes, the clinical expression of systemic lupus can vary depending on ethnicity. It is often more severe in black-skinned populations (especially Caribbean and African-American), Hispanics, Asians and Native Americans. In these populations, the frequency of lupus is 2-3 times greater than in Caucasian patients. There is also an increased risk of kidney damage. Moreover, there are also more sequelae related to lupus in these populations, but this may also depend on the variability in access to care sometimes observed in these populations.