Systemic lupus erythematosus (SLE) with subcutaneous granulomatous nodules, joint symptoms, and a positive latex titre for rheumatoid factor may cause diagnostic confusion with rheumatoid arthritis (RA). This has been a subject of renewed interest in recent medical literature, but reports of nodules in SLE outside the subcutis are rare. This report presents a patient with SLE and with a vocal cord granulomatous nodule, arthralgia, and a positive latex titre for rheumatoid factor. The laryngeal manifestations of SLE are discussed.