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Old 05-19-2006, 03:50 PM   #1
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Mickey32 HB User
malar rash

Hi everyone. I don't have a diagnosis of Lupus, but I do have Hypothyroidism, Raynaud's, Sjogren's, and MS. I was just wondering if it's possible for the malar rash to be on your chin and forehead. I was diagnosed with the malar rash at first at the same time I was diagnosed with Raynaud's. It was my neuro at the time who diagnosed me. Then my rheumy said it was starting to look like rosacea. I've been going to a dermy for about a yesr and a half now, and I've tried three different things for the "rosacea" but everything I try seems to bring it out even more, especially if I'm in the sun. So, I'm wondering if it really is the malar rash that I have, and if it's possible to have it on the chin and forehead also. I also have a lot of joint pain, dry eyes, fatigue, and muscle pain. Thanks for reading.

Michelle

 
Old 05-21-2006, 11:06 AM   #2
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goldenwings HB User
Re: malar rash

Hello Michelle,

Just to speak from my own personal experience of having the butterfly/malar rash - it normally extends over the cheeks and bridge of the nose. It can range from a slight blush look to at times a severe eruption with scaling. The outer parts of the nose & cheeks where the folds at the sides of your nose are and where they meet the upper lip are usually not affected in lupus. I personally haven't heard of the malar rash affecting the parts of the face you ask about. Having said that, rashes are common in lupus, and you may have a type of lupus that affects the skin in this way.

One other thing that I would suggest you might look into is PLE - polymorphc light eruption - this is a rash that gets worse in the sun, as you mentioned that your does and is not just on one part of the face. Just a thought.

Take care.

goldenwings
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Last edited by goldenwings; 05-21-2006 at 11:09 AM.

 
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Old 05-21-2006, 03:16 PM   #3
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Re: malar rash

Thanks for the reply Goldenwings. I appreciate the info. I will also look into PLE. Thanks again, and I hope you are doing well.

Michelle

 
Old 05-21-2006, 06:05 PM   #4
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Re: malar rash

Hi, Mickey32. Further to what GW just posted...

Are you positive for anti-Ro, which is very often seen in Sjogren's? FYI, this is the same autoantibody that's seen in most of the people who have SCLE = subacute cutaneous LE. SCLE is a "subset" of SLE, which can extend through the entire range of SLE but is *thought* to carry less risk of kidney & CNS involvement.

SCLE has two forms of common rashes unique to it: papulosquamous SCLE (looks like psoriasis but isn't), and annular SCLE (target-like red rings). Both tend often NOT to scar or depigment, or not to the same degree as "discoid" (see below). People with SCLE are also "eligible" also for discoid and malar rashes, but the two rashes described above are the ones that predominate. People with SCLE are often horribly photosensitive.

Yet another lupus rash, discoid, is the kind that causes major scarring, depigmentation, and hair loss.

I have SCLE. I had the "annular" form of rash on my upper arms and torso for many years, before FINALLY finding a rheumie who "got it"---and "got" all my other related issues. I did get one lousy lesion on my nose, and naturally it was a "discoid"---it left a vivid scar.

Have any of your drs. mentioned the SCLE form of lupus to you? Have you tested positive for anti-Ro? Maybe you could ask your drs. some questions in this vein, as one logical place to start. Anyway, good luck with this. Vee (rash-free for 5+ years, on Plaquenil, & now very sun-avoidant)

 
Old 05-22-2006, 06:34 AM   #5
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Re: malar rash

Hi Vee. Yep. I tested positive for Anti-Ro in December after two years of testing for Sjogren's. My rheumy then put me on Planquenil. She even did a follow up blood test in March to nake sure it wasn't a false positive or anything, and I noticed after getting a copy of my tests that they came back higher than the first test. I've also noticed that I have been getting some red spots on my arms that seem to come out more in the sun. One is kind of circular with a shade of my natural skin in the middle, and the rest are smaller red spots. I will look into SClE as well. My grandmother had Discoid Lupus. Thanks for the info. I really appreciate it.

Michelle

 
Old 05-22-2006, 08:19 AM   #6
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Re: malar rash

Michelle, You are entirely welcome. It was your mention of Sjogren's that put my brain (such as it is ) into gear. Dr. Daniel Wallace writes a bit about SCLE rashes in his lupus hardcover, found in many libraries and bookstores. Not sure if Dr. Robert Lahita, another well-known rheumie/author, also writes about SCLE, but I'd guess "yes".

FYI, I know personally only one other women who had the annular form of SCLE rash. She also tested positive for antiphospholipid syndrome, positive for anti-Ro & anti-La, positive for ANA, was anemic, had to be on steroids, and required multiple shoulder joint surgeries to remove spur-like growths.

Also FYI, I had just the "papules" for 4 years = red raised bumps, like mosquito bites but not itchy. Then they'd bloom into rings, with normal skin in the center, just like you wrote. (The papules are the neophyte form of the rings, I think.) I got so bad in the next 4-year period that I'd have all stages at once: new papules, almost-faded rings, rings 2 months old, rings 1 month old, & rings just starting to expand outward. Looked like a crazy quilt!

Anyway, good luck, Michelle. I hope you get answers quickly & really guard against sun exposure. Given that your dr. & you already know you're positive for anti-Ro, that sounds like you've made real progress already. Warm wishes, Vee

 
Old 05-23-2006, 02:21 PM   #7
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Re: malar rash

My butterfly is across my nose and cheeks, but there is a patch on my forehead and on my chin too. It also gets redder the worse I feel

 
Old 05-23-2006, 02:33 PM   #8
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Re: malar rash

is it possible to post images here? If so I could put a pic of my butterfly rash.

 
Old 05-23-2006, 06:21 PM   #9
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Re: malar rash

Hello squarah,

I'm not sure that posting images is allowed. You would have to check the rules.

Many lupus patients may have other rashes too that are giving the overall facial rash, but the typical malar rash only affects the nose and cheek area and gives the appearance of "butterfly" wings. As has been spoken of before other lupus rashes can be visible and affect other areas of the face.

Take care.

goldenwings
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Old 05-24-2006, 02:48 PM   #10
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Re: malar rash

Hello squarah,

I have scarring discoid lupus. I also have hypothyroidism. I frequently have a rash on my face that does not look like the typical mylar rash. My Rheumy and Dermi have both told me it is from a hormone imbalance ( thyroid ). My oldest son has been hypo thyroid since 8 or 9 years of age. He is now 36. He has had this same rash and it is very sun sensitive in both of us. No one has ever been able to tell me if it is related to the lupus as well as the thyroid, many things seems to be connected. I only mention it because I don't want you to feel all alone. Aside from the itch and the redness it doesn't appear to do any harm.

May God Bless Us All
Patience 50

 
Old 05-28-2006, 08:05 AM   #11
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goldenwings HB User
Re: malar rash

Hiya everyone,

Just to say that there is a new thread that has been started dealing with ACLE and gives information about the type of rash that has been described here i.e. affecting the brow and chin.

Thought this might be of interest.

Take care.

goldenwings
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Old 05-29-2006, 12:25 PM   #12
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Re: malar rash

Does this rash come and go or is it always there? There are times when the butterfly really shows but at other times you don't see it. And mine is not what I would think of as a rash but it looks more like it is a flushing rather than a rash.
BVan (Betty)

 
Old 05-29-2006, 12:49 PM   #13
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Re: malar rash

Hi Betty,

Yes, the rash does come and go. Like you I have often wondered why it is called a rash. I think it looks more like a bright blush. My scarring discoid marks are different of course, but when my face get red it looks like a bright blush.

May God Bless Us All
Patience 50

 
Old 05-29-2006, 01:43 PM   #14
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goldenwings HB User
Re: malar rash

Hiya Betty,

Yes my butterfly rash is always there. When I am flaring, it is more defined and noticeable. My face always loses its colour though, and my husband says I am always very pale when unwell so maybe this is why the rash is more obvious.

Sometimes my face gets quite itchy and I do haver very dry skin anyway but the actual malar rash for me isn't raised or very prominent.

Take care.

goldenwings
__________________
I am not a medical doctor, I only speak from my own experience of the illnesses I discuss here.

 
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