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A butterfly rash can just be redness. It is often transient, and brought on by sun exposure, overheating, alcohol, or can just come "out of the blue". A negative ANA does not rule out lupus, as it could be too early to be positive, or a person can be one of the 4-5% with lupus who do not have a + ANA. So it bears watching and retesting, especially if other symptoms are present. Every 6-12 months retesting is reasonable, depending on what else is going on.

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