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Janmar123, Following are lupus-specific rashes. Much of this info is from Dr. Daniel Wallace's lupus hardcover, found in most libraries & bookstores. 1 thru 3 are the common lupus rashes; 4-6 are rare. FYI, most of these typically do NOT itch. Then following the lupus-specific list are some skin conditions that aren't lupus-specific but are more common in people with lupus.

1. Discoid. These scar &/or depigment. Seen in people classified as having DLE, but people classified as SCLE & SLE are also "eligible". ANA is positive roughly 50% of the time in people classified as having the DLE subset.

2. SCLE (two distinct rash types). These tend NOT to scar or depigment. Are seen in people classified as having SCLE, SLE, and DILE (drug-induced lupus). About half of those classified as having SCLE meet 4 or more of the criteria for SLE, but they tend not to meet the worst criteria; for example, kidney & CNS problems are thought to occur less often in SCLE than in SLE. Patients tend to be VERY photosensitive; and the lesions tend to be resistant to skin creams & antimalarials. Anti-Ro is the most common autoantibody found, but perhaps 1/3 also have positive rheumatoid factor. ANA is positive only about 70% of the time in people with SCLE.
2a. SCLE annular. Immature form is red raised "papules". In mature form, the papules expand into circles (usually smaller than palm of hand), before expanding outward & losing circularity.
2b. SCLE papulosquamous (a/a psoriasiform). This form looks like psoriasis but isn't.

3. Malar (butterfly). This is the classic facial rash heavily associated with classic SLE, but it can been seen sometimes in SCLE & DLE, too.

4. Bullous lupus. Rare. Large fluid-filled blisters.
5. Tumid lupus. I *think* this is a DLE variant, in which a larger skin area becomes affected, as opposed to multiple small lesions. I've seen pics of it on the throat area.
6. Panniculitis (Profundus). Rare. Inflamed fat pads underneath the skin create bumps, but without signs of a surface rash.

Additionally, people with any kinds of lupus are also more prone to certain non-lupus-specific skin problems. e.g., pigmentation changes, including vitiligo; urticaria (itchy hives or welts); cutaneous vasculitis (red or black dots or hard spots that can stay mild or can ulcerate); purpura & ecchymoses (black & blue marks under the skin; can be mild or serious); Raynaud's (fingers turn red, white or blue, due to cold, stress or vibration); and livedo reticularis (lacelike mottling under the skin).

Janmar, there are probably some I've left out or have never heard of. In your shoes, I'd want a dermie to look at this itchy neck rash. It may not be a lupus-specific rash. Or, as you say, you may have a skin reaction to your old generic antimalarial. Also, I've read that overuse of steroid creams can thin the skin, over-dry it & cause it to itch. Just curious: did your neck start to itch before or after you started using a steroid cream on it? Also, are you blocking sun religiously?

You could find pics of many of these using the SEARCH BOX to the upper left; but, again, only a skin biopsy is definitive.

Hope there's something here that helps & that you get answers from your drs. soon. Hang in there! Sincerely, Vee (P.S. I had the SCLE annular form on my upper arms, back & torso, about 4 new batches a year for 8+ years. My rashes did NOT itch. I've been rash-free for 7 years now, since starting Plaquenil & avoiding and blocking sun religiously. Also, all my life I've reacted to certain fabrics, like wool; and to certain soaps & fabric softeners; gotten itchy patches on my hands; etc. But I don't believe these last things are lupus-specific---only my annular rashes were, I think.)





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