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Doctor insights on: How Long Does The Malar Rash Last In Lupus

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Recently diagnosed with lupus and started 5mg prednisone and 200 mg plaquenil (hydroxychloroquine) twice a day. How long until the malar rash goes away? Meds started 3 weeks

Recently diagnosed with lupus and started 5mg prednisone and 200 mg plaquenil (hydroxychloroquine) twice a day. How long until the malar rash goes away? Meds started 3 weeks

Malar rash: It takes time. Be patient. It is important that you always use sunscreen on this area and never to allow it to get sunburned. Additionally, consider seeing a dermatologist in another 5 weeks if the rash is not starting to get lighter. Even taking a picture and comparing every 4 weeks would give you a starting point. ...Read more

Butterfly Rash (Definition)

"butterfly rash" is usually in reference to lupus and refers to a red rash, usually made a lot worse with sun exposure, that shows up across the cheeks and nose. Apparently, someone thought this reminded them of the ...Read more


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Malar rash+fatigue, last CBC show slight up htc, rbc, normalt3, t4, tsh, c3, c4, urea, creatinine, ANA -ve, more epistaxis, I am panic bcuz rash like lupus rash

Malar rash+fatigue, last CBC show slight up htc, rbc, normalt3, t4, tsh, c3, c4, urea, creatinine, ANA -ve, more epistaxis, I am panic bcuz rash like lupus rash

See details: I would doubt lupus. The rash is more likely to be rosacea. Epistaxis is not a feature of lupus especially if the CBC is normal. Look for other causes. ...Read more

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Is a malar or "butterfly" rash always indicative of lupus? What else could it be?

Is a malar or "butterfly" rash always indicative of lupus? What else could it be?

Not always lupus: A malar or "butterfly" rash is one of the signs of possible lupus, but other rashes can appear similar, including eczema, rosacea, seborrheic dermatitis, allergic contact dermatitis, and others. A complete history, physical exam, and possible skin biopsy and/or blood test can usually distinguish between these rashes. ...Read more

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Can dermatographia associated with lupus, I have only malar rash and dermatographia, all other things normal?

Can dermatographia associated with lupus, I have only malar rash and dermatographia, all other things normal?

Dermatographia: The exact cause of dermatographia is unknown. However, it is more associated with allergies rather than lupus. Symptoms of dermatographia usually go away on their own, and treatment for dermatographia generally isn't necessary. However, if the condition is severe or bothersome, your doctor may recommend antihistamine medications such as diphenhydramine, fexofenadine or cetirizine. ...Read more

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What is the percentage of developing the malar "butterfly rash" for Lupus patients? I was informed that only 30% will suffer from it.

What is the percentage of developing the malar "butterfly rash" for Lupus patients? I was informed that only 30% will suffer from it.

It depends: Avoid sunlight and you'll probably avoid the butterfly rash. And sun exposure may not even trigger it. Lupus is diagnosed by checklist -- a certain number of checks, with some groups weighted, gives the diagnosis -- and the diagnosis itself is only a guide to "what should we do" for this still-elusive illness. Best of luck. It's an especially challenging disease. ...Read more

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Early on in the course of Lupus could all blood results be negative/normal? still, ill and getting blatant malar rash despite neg results

Early on in the course of Lupus could all blood results be negative/normal? still, ill and getting blatant malar rash despite neg results

Very unlikely: Have the rash biopsied and then you will know. Discoid lupus often has a negative ANA but with systemic lupus a negative ANA is very rare. ...Read more

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Does Rosacea appear Brown after Sun exposure? Does Lupus Malar appear Brown after Sun exposure? What type of Butterfly Rash turns Brown in Sun?

Does Rosacea appear Brown after Sun exposure? Does Lupus Malar appear Brown after Sun exposure? What type of Butterfly Rash turns Brown in Sun?

Malar rash: Melasma is a very common patchy brown, tan, or blue-gray facial skin discoloration, usually seen in women in the reproductive years. It typically appears on the upper cheeks, upper lip, forehead, and chin. Lupus may cause a butterfly rash which can be exacerbated by the sun. A malar rash associated with lupus may be erythematous (red) or brown. ...Read more

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Would a skin biopsy for lupus still come up positive, even without a malar rash?

Would a skin biopsy for lupus still come up positive, even without a malar rash?

It can: There are many types of rash that can be seen in lupus. While the mal;ar or butterfly rash is the most common there are other lesions including the discoid rash of lupus. Many other rashes are also described as being seen in lupus. Even normal appearing skin can be positive for lupus using special stains and techniques. ...Read more

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Can you have a malar rash on your chest and back? I do not have it on my face. I have several other features of lupus.

Can you have a malar rash on your chest and back?  I do not have it on my face. I have several other features of lupus.

Malar on the face: The malar rash is specific for the face, other rashes are also associated with lupus. Depending on your symptoms, best is to consult a rheumatologist for proper diagnosis. A skin biopsy, if in doubt, can also elucidate some of these rashes. ...Read more

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Why someone 15 minutes in the Sun and he will get Malar rash butterfly shape on face? Is it lupus? Isn't rosacea soberiac dermatitis different shape

Why someone 15 minutes in the Sun and he will get Malar rash butterfly shape on face? Is it lupus? Isn't rosacea soberiac dermatitis different shape

Needs Dermatologist: Butterfly rash of Lupus is red or purplish. It involves the bridge of the nose. Note it spares the nasolabial folds of the face. Patient can get blood tests to clarify ...Read more

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All blood tests for lupus neg. 4 times- just have clinical symptoms for a year, including malar rash-could still be lupus? Lyme test was + 1 year ago.

All blood tests for lupus neg. 4 times- just have clinical symptoms for a year, including malar rash-could still be lupus? Lyme test was + 1 year ago.

Unlikely: Negative autoantibodies make lupus unlikely but not impossible. You can always get a 2nd opinion. If the rash is present elsewhere besides the face have a dermatologist biopsy it and send it for evaluation including a lupus band test. ...Read more

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Any other causes of malar rash besides lupus & lyme? It definitely isn't rosacea or seb derm due to appearance

See details: Lyme does not cause a malar rash. The most common cause is rosacea. If you have lupus, the logical cause is lupus. ...Read more

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If ANA is positive 1:320 pattern is nucleolar n malar rash BUT was on MINOCYCLINE 4months isn't falsepositive or induced lupus is Homogeneous pattern?

If ANA is positive 1:320 pattern is nucleolar n malar rash BUT was on MINOCYCLINE 4months isn't falsepositive or induced lupus is Homogeneous pattern?

ANA explanation: Usually drug induced lupus or drug induced ANA patterns are antihistones and are homogeneous. Nucleolar patterns of ANA (antinuclear antibodies) are associated with Progressive Systemic Sclerosis. By itself an antinuclear antibody test that is positive is not a diagnosis. ...Read more

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Why would a dermatologist assume a Malar rash is Rosacea and not Lupus because it is not a raised rash? I have read Lupus can appear as flat lesions?

Why would a dermatologist assume a Malar rash is Rosacea and not Lupus because it is not a raised rash? I have read Lupus can appear as flat lesions?

Rosacea vs lupus: Malar rash of lupus is flat or mildly raised.

It spares nasolabial folds.

Difficult cases may need a biopsy and immunoflorescence can clinch the diagnosis ...Read more

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Esr, c3, c4, total hemolytic complement are all high, negative ana, malar rash, could it be lupus?

Esr, c3, c4, total hemolytic complement are all high, negative ana, malar rash, could it be lupus?

Very unlikely: Only a few patients with a malar rash on their cheeks have lupus. You have had appropriate laboratory tests and none are suggestive of lupus except the elevated esr, which is a very nonspecific measure of inflammation. See a dermatologist if you have done already done so. ...Read more

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Should I seek second opinion? All rheum tests neg for lupus but continuing malar rash, migrating joint/muscle pains & fatigue. Want answers?

Probably yes: All the symptoms you have may or may not be related to sLE. There is ANA-negative sLE, but it is very rare and hotly debated whether it actually exists. If you have not yet seen a rheumatologist, make sure you see one. If you have, you may want to go to one of several excellent university-affiliated rheumatology clinic. ...Read more

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Malar rash, photosensitivy,sicca,mouth/nose sores, Recurring flares, leukopenia, ANA 1:640. All other labs neg. Rhuem dx'd lupus. Possible w/normal labs?

Lupus: Seems consistent with SLE. Need Rheumatologist follow up and specific anti double stranded DNA and other labs. SLE affects your kidney and can cause pericarditis. Immediate follow and management is helpful. ...Read more

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My lupus flares are Skin manifestation only(malar rash)plus fatigue. But ESR n CRP keeps coming Normal including ANA.on plaquenil (hydroxychloroquine). Was dx not correct?

Maybe, maybe not...: You may have a type of lupus called subacute cutaneous lupus erythematosus(SCLE)which can often be a milder form of systemic lupus(SLE) and can be seen with normal inflammatory markers (ESR). Can also be Sjogren's. However, half of people with SCLE also meet criteria for full-blown SLE. SCLE patients can have more serious organ involvement than just skin that should be checked for. See rheumatologist ...Read more

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Saw rheum for malar rash, joint pain, muscle pain, fatigue. He ran FBC, ENA, ANA, CK Enzyme, Complement. All normal/neg so he said no lupus. Confused?

Saw rheum for malar rash, joint pain, muscle pain, fatigue. He ran FBC, ENA, ANA, CK Enzyme, Complement. All normal/neg so he said no lupus. Confused?

See details: There should be no confusion. You don't have lupus. A malar rash is most often the result of rosacea and the generalized aching and fatigue can have numerous causes. Ask the rheumatologist if it is not lupus, what is it? ...Read more

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How long is it supposed to it take for plaquenil (hydroxychloroquine) to get rid of the lupus butterfly rash?

How long is it supposed to it take for plaquenil (hydroxychloroquine) to get rid of the lupus butterfly rash?

Give it 6 months: Plaquenil (hydroxychloroquine) takes up to about 6 months to reach its maximum effect. It often has little or no benefit in the first 6 weeks of its use. ...Read more

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Immunologist agreed I have malar rash. How is lupus dx'd since we can't rely on antibody or inflammatory tests w my immune deficiency and steroid tx?

Immunologist agreed I have malar rash.  How is lupus dx'd since we can't rely on antibody or inflammatory tests w my immune deficiency and steroid tx?

Management/workup: The initial workup will include renal function testing and tests for circulating antibodies. Your steroid treatment may affect the tests for inflammation, moreso than autoantibodies which are still detectable even while being treated with steroids. Avoiding and treating infections, including CMV will be part of the management. I hope that this helps. ...Read more

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Is it ok to exercise during a lupus flare? I felt great until I caught a viral infection a month ago, now I have worsening joint pain/swelling/stiffness, fatigue, malar rash and swollen lymph nodes.

Is it ok to exercise during a lupus flare? I felt great until I caught a viral infection a month ago, now I have worsening joint pain/swelling/stiffness, fatigue, malar rash and swollen lymph nodes.

Generally, yes: As long as it does not make the symptoms worse, light exercise may help improve the symptoms from the lupus attack — especially a mild one. If you have doubts, contact the physician that treats you for the lupus. ...Read more

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I was wondering is a butterfly rash always from lupus?

I was wondering is a butterfly rash always from lupus?

No: It is one of eleven criteria to diagnose, but in itself it can be due to many less harmful things including normal reaction tossing. ...Read more

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Is it possible to have lupus and not have butterfly rash?

Is it possible to have lupus and not have butterfly rash?

Yes: Though the butterfly rash on the cheeks is common, it is not always present. Some patients may never have an evident malar rash (the technical name). Interestingly, the name of the disease, which is latin for "wolf, " is based on the fanciful idea that the rash makes faces look wolf-like. ...Read more

Dr. John Chiu
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Rash (Definition)

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Dr. Cornelia Franz
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Rash (Definition)

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