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Thank you for your post. I actually finally got into see my Rheum. and he did confirm that it is the butterfly/malar rash. He said there are hundreds of different types of lupus rashes and that mine still looked like one because the rash did not cover my nose or nostrils and was the reddest on the cheeks and bridge of the nose. He prescribed me some prednisone and said to call him again if it comes back.
Hello there, You aid you have seen and tralked with a doctor regarding this question. The thing is with a 'true' malar rash the nose will be red as will the cheeks red but the 'folds' at the side of the nose remain white - it dees not affect the whole of that area.

I would suggest - this information is given from me not in a medical way at all but from a long term patient with SLE - that you look into and discuss with your doctors the following if you can:-

Subacute cutaneous lupus of which there are 2 major types. The first one looks like red pimples when the rash first comes out then as itpersists and then the 'pimples' become might/can become bigger. Patients complain about the rash being very itchy. The rash usually appears on the face, chest, or arms and commonly comes on after sun exposure, and can usually worsens after more sun exposure.

The second type starts out as a flat lesion and gets bigger by expanding outward. The center may become less red and may even clear up completely so that, after a while, this rash looks like many circular red areas with clear holes in their centres. It can appear on the face, chest, arms, and back. It is very sensitive to the sun and, like the other form of subacute cutaneous lesions can usually be very itchy. The rash of subacute cutaneous lupus usually heals without scarring, or leaves a non-depressed scar or area of depigmentation where the rash had been. The thing is also that people with subacute lesions are very sun-sensitive.

Chronic discoid lupus lesions are found in about 20 percent of people with SLE. Chronic discoid lupus also is found in people who have absolutely no trace of systemic lupus. In these people, the lupus is confined to the skin and these lesions are slightly elevated, pink or red areas which form crust or flakes on the surface. As the lesions mature, the central area becomes depressed and forms a scar. These lesions rarely are found below the chin and practically never on the legs. However, chronic discoid lupus frequently is found on the scalp and in the outer ear. Lesions are itchy and get bigger by spreading outward, leaving a central scar.

Hope this information is not too long drawn out, but I feel it is relevant to your question. If I can be of further help, please let me know.

Take care,

goldenwings :angel:

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