Butterfly rash: what is it?

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A butterfly rash on the cheeks and nose can be a sign of systemic lupus erythematosus or other conditions. It’s not painful or itchy, but can be uncomfortable due to its visibility. Treatment may involve anti-inflammatory medications or waiting for the rash to clear up. Lupus patients may develop the rash after exposure to sunlight and may keep logs to track symptoms.

A butterfly rash is a distinctive rash that forms on the cheeks and bridge of the nose in a shape that resembles a butterfly. Butterfly rashes are a classic sign of systemic lupus erythematosus, but they can also be associated with other conditions. People who develop butterfly rash and are unaware of any underlying medical conditions to explain it may wish to seek an evaluation from a dermatologist. The doctor can evaluate the rash and the patient to explore possible causes and make recommendations for further tests and treatment if needed.

In a classic butterfly rash, the rash is reddish to purple and may have a scaly appearance. It doesn’t itch and it’s not painful. The intensity of the rash can vary. Some people may develop only a slight discoloration, while others may develop very severe rashes that climb around the eyes and are clearly red and scaly.

While the rash isn’t painful or itchy, people may feel uncomfortable because it’s very visible. People with rashes tend to attract attention which can cause social awkwardness or irritation, especially in the case of people who get tired of well-meaning questions on their faces. Taking anti-inflammatory medications can sometimes reduce the intensity of the rash, and topical medications or creams may be applied depending on the cause. Sometimes, treatment simply involves waiting for the rash to clear up.

In addition to being associated with lupus, when it’s known as malarial rash, the rash can also be caused by rosacea and several other chronic conditions. People who notice changes in their skin should take note of when the changes occur and how long they persist, as well as list any activities they have recently been involved in, including taking medications, swimming in chlorinated water or spending time outdoors. All of these activities can contribute to the development of a rash.

Lupus patients may have light-sensitive skin and will develop a malarial rash after exposure to sunlight. The rash can also be a sign that a lupus flare is imminent, providing a warning to a patient who is familiar with the symptoms her body experiences prior to a flare. Some lupus patients find it helpful to keep logs or diaries to record their symptoms in order to familiarize themselves with warning signs and to track reactions to various activities, medications, and dietary changes.




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