Hi Cindy Lou
My hubby has little 'rough' patches on his cheeks.
he burns in the sun esp. when no sunscreen! his arms neck etc seem to heal quicker and no marks after. his face is quite marked, he wears a beard mostly and it helps protect the skin ... on his cheeks there are 'permanent' marks. he responds well to cortisone cream ... when he uses it! i nag when it gets inflamed but he is just such an old school guy not a new age metro with a beauty regime. i tease him with anti wrinkle cream (he is only 36)
Hi Postie ...
funny story (well i think so)
me dx SLE in 2003 ... my MIL absolutely freaked out about this ... then
hubby dx SCL in 2007 ... there are small 'permanent' marks on each cheek ... i call them this b/c they have so far never gone away, the inflamation lessens with sunscreen, and NO sun which is a wee little problem ... hubby is a passionate gardener and landscape designer (and fries in the sun?)
we are changing the core focus of his business so that he spends majority of his time designing at his desk and spends quality time in the garden ...
doesn't Seal (the music artist) have deep permanent scaring - always thought it was part of his look!
Keep well, A
Postie, honestly, I see only one course of action that makes sense: see a qualified dermatologist & be prepared be examined, have blood taken, and answer basic questions, such as---
What problems are you having *other than the rash*?
At its worst, what area does rash cover?
Are lesions large & discrete? Or tiny and run together?
Does it spare "folds" running diagonally along nose to outer edge of mouth?
Does it come & go? How long does it last? How long before it reappears?
Does it itch or burn?
Does it scar?
You mention dents. Do they appear *during* the rash, or *after* it fades?
Does it depigment? (Is affected skin lighter afterwards?)
Do you notice any correlation to sun or artificial UV light?
Does sun or artificial U/V light make it better or worse?
What facial product(s) do you use? (Product allergies can occur.)
Any recent cosmetic treatments (tanning bed, chemical peel, etc.)
Are you taking any meds, incl. OTC's?
You've read that rosacea & lupus "butterfly" are hard to distinguish.
Whether these could be "discoid" scarring lesions, I couldn't say, of course. I picture "discoids" as typically being discrete and dime-size or larger, but I could be terribly wrong!
Maybe the psoriasiform type of SCLE is also a possibility? Again, that's only for a DOCTOR to say! I've read that SCLE rashes *tend* not to scar or depigment, apparently meaning they *can* in some people. (You could ask.)
And maybe your rashes aren't lupus rashes. In addition to rosacea, I assume there are many other facial rashes possible!
I hope you make appt. with a dermatologist ASAP. You do NOT want permanent damage to your poor face. Another reason to do so: if the rashes are actually part of some broader condition, then you'll be on the path to diagnosis and help. Sincerely, Vee
I have the 4 criteria of lupus. Every 6 months I always get bloodwork done.
My rash is permanently always on my face and neck. It doesn't change in length or anything. It's always the same. I don't know what lesions are, but the little dents on my cheek are tiny. They are the area where the rash is on my cheeks. No other place.
The rash does not spare the folds. The rash never goes away. It's been there since I've been sick. It doesn't itch or burn and doesn't scar.
Since the rash never fades, the dents are always there. If I am in the sun less than 5 minutes, my face looks like a really bad sunburn.
I don't use any facial products. The dents on my cheeks are very small. They are like kind of dots. But indented in the skin.
The rhuemy definitely said my rash is a connective tissue disease and it doesn't look like rosacea.
Postie, the only reason I wrote those thoughts about rashes is that some of us had multiple specialists contibute to the Dx. For me, it was a dermatopathologist ( = dermie who does his own pathology, meaning labwork) and a rheumatologist. So that's why I was hoping another specialty could contribute findings, to help move your Dx along into something less "fuzzy".
Do I understand correctly that you're NOT on any meds...? And that this has gone on for 4+ years?
I think the odds of positive bloodwork vary by lupus severity. For a milder form like "discoid lupus", I think bloodwork results are negative. That doesn't mean it doesn't need treated, though! Goals would be to protect skin from further damage and to relieve whatever "constitutional" symptoms (fatigue, pain, etc.) are present.
Have you ever asked your rheumie to recommend a dermie? If I had a persistent rash, I sure would! I know being in limbo is hard, physically & emotionally (I spent years there), so I feel for you. With my best, Vee
I'm not on any meds. This has gone on since 1998--longer than 4 years. That's when I got sick, so my symptoms were kind of vague. But in the last couple of years, the bloodwork is changing. My neutrophils are lower than normal since last year. That's a new symptom.