Dear chick4457, From the Board here, you can find some excellent info on lupus. See (1) the "Resources" tab above. From it, go into MedLine Plus, then rheumatology, then lupus. (2) Look at the "sticky posts" at the front of the Board. In the one about test results, there's a source mentioned that has a great deal of info, including various lupus rashes.
I guess the main things I want to leave you with here, just starting off, are
(1) There are different kinds of lupus. Systemic lupus (SLE) is the "big lupus", but there are also lesser "subsets". Discoid (DLE) is the lightest one; scarring rashes are its hallmark. Subacute cutaneous (SCLE) is the intermediate one, with rashes (either annular = circular, or psoriasiform = looks like psoriasis but isn't. In SCLE, true systemic problems can occur that may or may not include organ involvement; but some cases are mild (rash & fatigue, for example).
(2) ANA is only a threshold test, and results may vary from test to test. Most people (not all) with SLE have at some point(s) a positive ANA. But the *subsets* are different! In DLE, maybe only 50% (or so) ever test positive. In SCLE, maybe only 70% (or so) ever test positive. Therefore ANA may not be all that needs to be looked at. Many dermies & rheumies order the ANA but *also* all sorts of other more specific autoantibody & complement tests.
(3) If someone has a recurrent rash, a skin biopsy can be very useful because lupus rashes have distinct characteristics.
I had episodic problems from early childhood. By my 20's, I had chronic, severe IBS. Then each year, more stuff: fatigue, migraines, stones, anemia, joint pain, urinary problems, neuro-like tingling, rapid heartbeat, etc. It wasn't until my late 30's that I got an early form of the SCLE annular (circular) rash, on my arms & back. For 4 years it looked like mosquito bites; but after that, when it reappeared, those welts "morphed" into circles. Didn't itch and didn't scar; and it was clearly photosensitive. (I looked like the Tatooed Lady from the circus.
I finally grew so miserable with local drs. that I took myself to a teaching hosp. rheumie in Manhattan. On his very first try, I tested positive for anti-Ro. But, interestingly, I have NEVER tested positive for ANA---which is why I wrote that caution about ANA.
Has your daughter seen a rheumie? A dermie? What does your daughter's rash look like? Does it itch? Scar? (etc.)
Anyway, you can read better explanations in the materials I suggested. Why don't you read a bit, then fire back more questions & comments? People here always have plenty to chip in, it seems, and are always ready & willing to chat. Sincerely, Vee