Rosacea or Malar Rash?

[bev2002]

How can you tell the difference between the two and who has been wrongly diagnosed?

[grannyjogger]

Hi Bev. I had what I thought was a very clear malar rash - typical butterfly shape across my cheeks and nose. I was referred to dermatology and was told it was definitely rosacea because the rash was also on my chin which distinguished it from a malar rash. My GP also said it was a typical rosacea rash for the same reason. I use Metrosa cream when it flares up which helps.

[bev2002 in reply to grannyjogger]

Hi a nurse and two gps think it is a Malar Rash but when they sent the photos through to the immunologist he said it was hard to see by the photos and could it not be rosacea.x

[grannyjogger in reply to bev2002]

The dermatologist said that they can do a biopsy to confirm what the rash is, but it would leave a scar. As mine was very typically rosacea he did not feel it was necessary.

[bev2002 in reply to grannyjogger]

Ahh right.the problem is mine comes and goes unless I am poorly or having a long flare so I suppose they are probley going to just see what my next bloods are x

[grannyjogger in reply to bev2002]

That's always the trouble with symptoms, they come and go. When I eventually got a dermatology appointment the rash wasn't very noticeable but I had luckily managed to get a couple of clear photos when it was at it's worst. x

[MOOG144]

Hi Bev

I never had the butterfly rash... or so I thought as I thought it was an actual rash in all instances. My Rheumatologist however told me to do the 'pinch' test.

If you pinch the apple of your cheek and it feels solid with no give then you more than likely have the Lupus rash... assuming you have been diagnosed with Lupus I guess.

He did this to me then got me to pinch his cheek and there was a definite difference.

Don't know if it helps but it has allowed me to spot it in myself.

Xx

[Lupiknits]

I initially just went to a locum GP who was in a hurry and decided on rosacea. He prescribed a cream. Fortunately I did a patch test on my leg because I have very sensitive skin. It ripped that patch of skin off.

I’ve learned so much from this forum that I’m sure it’s a malar rash. Since then I’ve taken selfies which have elicited “Oooh, lupus” responses. The rash usually coincides with flares. It really isn’t a big problem for me, apart from vanity! I use various French redness soothing products from Avene and Vichy when they are on offer.

No real diagnosis, but I can usually keep on top of it.

[lupie46]

I was a victim of misdiagnosis. For three years I was treated for rosacea and the treatment made my skin horrendously worse. A locum doctor at my gp practice who I saw about something else asked what dermatology had said about my "rosacea". I hadn't seen a dermatologist. She sent me to dermatology. I walked into that appointment and the expression on the dermatologist's face was priceless. She fetched a colleague in and they made knowing looks at each other. I had biopsies taken there and then. That was the beginning of my SLE diagnosis.

It later turned out that I had both rosacea and lupus.

[Chanpreet_Walia LUPUS UK]

Hi Bev2002,

A malar rash is usually a pink or redish-coloured rash which mainly occurs on the cheeks and the bridge of the nose. According to The Lupus Encyclopaedia, the rash of acute cutaneous lupus which includes the ‘malar rash’ (butterfly rash) can “last a few hours, a few weeks or sometimes longer”. A malar rash is generally not permanent; it often appears when disease activity is higher or when exposed to certain triggers such as UV light.

Rashes commonly mistaken for lupus include rosacea, seborrhoeic dermatitis and occasionally, allergic reactions of the skin due, for example, cosmetics. To learn more about lupus and the skin, read our booklet at lupusuk.org.uk/wp-content/u...

[mimiof9]

Hi! Can anyone relate to this...Every afternoon for the last several years my nose gets red. It's an obvious, defined red. It doesn't spread across my cheeks like the typical Lupus butterfly rash, but is noticeably 4-5 shades brighter than the rest of my complexion. In my pre-undiagnosed-auto-immune-disorder-days my temps were never normal. Usually 97.7. When I started noticing a red nose (approx. 5 years ago), I could always count on having a low-grade fever of 98.9 to 99 or higher. It may not seem high to most, but when your norm hovers around 97.7, two degrees higher makes a huge difference in how achy my body feels. So in closing what classification of a rash is this? Thanks in advance!

[Jmiller623]

I always found that rosacea comes and goes like flushing with some underlying acne. When I get malar it’s like leather on my cheeks, nose and just above on my forehead. The skin is actually red and puffy. It feels like a mild sunburn. It lasts for days to weeks and isn’t as pimply/rough like rosacea. It also got better with Plaquenil. I also feel like heat and sweating exacerbate rosacea whereas sunlight really brings out malar for me.