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Old 07-26-2009, 07:58 AM   #1
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Lupus rash

how do you distingish the difference between a lupus rash or dermatology problem. I haven't been out in the sun lately (walking) cause I'm packing/moving right now. I have this rash noticed today going across my cheeks, not on my nose but going out from it on each side on my cheeks. It's splochy but if it was say filled in all the way, it would look exactly like a butterfly shape. Flat/red/no bumps/and it burns a little bit.

I was diagnosed years ago with early stages of Lupus from a rhematologist, my blood work wasn't specific but I had positive ANA's homogenous pattern 1:320 titer. My PCP said it was Fibromyalgia and that's the diagnosis I've stuck with having. I don't go to a rhematologist anymore.

 
Old 07-27-2009, 05:29 PM   #2
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Re: Lupus rash

that rash is not so red today, it looks at least 1/2 better so I'm not going to worry about what it could be

 
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Old 07-28-2009, 03:08 AM   #3
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Re: Lupus rash

Neveragain, I think the only way to determine for sure if a rash is a lupus rash is by having a dermatologist do a skin biopsy & also perform immunofluorescent stain tests on the skin punch. From what I've read in Dr. Daniel Wallace's hardcover lupus book, under the microscope lupus rashes look much alike, with only subtle variations. The stain tests are what can really lock in the skin Dx. Lupus rashes will often (alas, not always) light up in "lines" considered very specific to lupus. Such lines prove you have a lupus rash, but not the precise kind, meaning the stain tests don't sort out malar vs. discoid vs. subacute cutaneous, etc. The dermie decides the kind---malar vs. discoid vs. etc.---by its look & behavior.

If you have a lupus-specific skin rash, it's concluded that you have lupus *to some degree*. If you meet 4 or more ACR criteria, it's systemic; if not, it's some lesser "subset".

Anyway... that's how the skin diagnostic process was explained to me, but please read the above in light of my being ONLY A DUMB PATIENT! Your rheumie, dermie, etc. could explain it professionally!

Since that rheumie told you some years ago that he thought you were in the early stages of lupus, how have you felt overall? Do you ache, get tired, etc.? Do you have regular physical checkups, annual bloodwork (for standard CBC, etc.). and urinalysis to check for protein in urine? If I were in your shoes, I'd probably not only watch for facial (etc.) rashes but make a point of having annual checkups---and, of course, following thru immediately on any new or worsening symptoms. I hope this helps some & that you're feeling well. Sending best wishes, Vee

 
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