What is this red, hot, raised rash on my face?

I've had this very red, often burning hot rash over my nose and cheeks for some time now. I also have a large variety of symptoms such as joint pain and swelling, fatigue, a high positive ANA etc, but no diagnosis (I am seeing a rheumatologist). Recently what was just a flat, red (sometimes purple) "rash" or blush I guess, is now covered in tiny little bumps. Not like spots, but very diffuse over the cheeks. There is none on my head or chin or anything, but the rash (and symptoms) is highly photosensitive. I hate it. It looks awful sometimes.

here are a couple of pics



3 Replies

  • Hi,

    Your history and photos would suggest a differential diagnosis of either rosacea or cutaneous lupus. With your joint symptoms, fatigue etc, it is appropriate to see the rheumatologist, for sure, but it would also be helpful to see the dermatologist for a closer inspection of your skin, clarification of some of the finer points of your history, and to consider the merit of a skin biopsy, if felt to be necessary, to confirm a diagnosis. Once you have a diagnosis, then the correct treatment can be considered. Until then, I would suggest avoiding triggers for the rash, specifically, a total sunblock due to the photo sensitivity you described. I recommend Heliocare SPF 50, Gelcream Light, as this is tinted, has a matt finish, and will both protect as well as tone down your redness. There are many other blocks with a tint, including some of the Sunsense SPF 50+ products. Find one you like, and use generously. Ask your GP for consideration of a referral to the dermatologist now, so as not to delay things., after all getting that all important diagnosis confirmed, so that definitive treatment can be commenced to control the problem, is paramount. Good luck!

    Dr Mark

  • thank you for your reply, that is very helpful. I will certainly try heliocare spf50. I've had numerous blood tests and have been told that despite my symptoms (for the last 6 years) it isn't lupus as all other tests are negative - including all my antibody tests apart from the ANA. But I will see my GP next week and ask to see a dermatologist, in the hope that doing so might lead finally lead to a diagnosis, before this gets any worse. If a simple biopsy could provide me with a diagnosis after all this time, it would be such a relief. Thank you again

  • Dear happyp just want to say good luck as having any skin thing developing on your face is just the most horrible thing to happen. Hope you don't have long to wait for dermatology appt

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