Is this a lupus rash?

[elizabeth-57]

Does anyone think that this is a lupus rash. It keeps flaring up. This year I’ve had 2 courses of steroids. I am also on hydroxychloroquine which I’ve been on for 10 years now. In June I started on methotrexate. I have a phone call tomorrow with the rheumatologist nurse. Is it worth asking to see a dermatologist?

[Lizard28]

It doesn’t look like my lupus rash but everyone is different, worth mentioning it while you have it as they could do a biopsy to check what it is. I get bumps under my skin if the sun catches me before my sun cream goes on, a bit like prickly heat as well as my lupus rash which I’ve got under control atm. It’s also itchy. Because I have freckley skin, it’s not as noticeable. Defo mention it or take a photo to show them.

[LuluM25]

From my own experience I'd say yes, it's probably a lupus rash and yes, ask to see a dermatologist. I had little sprinkles of rash each summer for around 30 years and had steroid creams that did very little. But eventually the rashes went when the sun went and the weather was cooler.

However in May 2018 a rash started on my forehead and spread to all upper exposed areas very quickly - a deep crusting, breaking open, sore and very noticeable rash! GPs prescribed steroid creams, no improvement. After 6 weeks of still getting worse, me getting desperate, a different GP searched for the soonest specialist appointment and I saw a dermatologist who immediately knew what to do.

Treatment was highish dose oral steroids which started to work within 4 weeks. In other words go to someone who has the knowledge and experience and who incidentally I am still seeing on a regular basis. Your GP and rheumatologist don't know skin, it's not their area, so ask for a referral and the soonest appointment you can get. Good luck.

[Caramia1964]

It doesn’t look like my lupus rash to be honest .

[KnitSewPurl]

I would request to see a dermatologist to confirm whether it is Lupus Rash as everyone is different and they come up differently . Mine come up in red lumps and they grow then fall off. They start off very tiny raised lumps it can be any where on the body from head to feet. Had it even on my face. They call my spot lesions. When they start to end cycle red - the end cycle it is silvery like thin paper. I only get them each time after a flare up

Depending on where mine is they dont hurt unless they are on areas very close to the bone /skin surface area.

So do see a dermatologist.. Mine was diagnosed by one.

[LuluM25]

Just an afterthought to Elizabeth - the dermatologist may do a biopsy to determine that it is a lupus rash and what kind of lupus rash. You'll then have a medical diagnosis. It's usually a mini biopsy so nothing to worry about.

[elizabeth-57 in reply to LuluM25]

Hi, thank you for the advice, much appreciated. I did ask the rheumatologist nurse about seeing a dermatologist and if it could be a lupus rash. She wasn’t sure as she obviously not seen it, but did tell me my blood tests were all normal in June. Although when I went to see the consultant in June I had a similar rash on my arms, legs and neck. He said it was a lupus rash and prescribed methotrexate as well as my hydroxychloroquine that I’ve been on for 10 years since been diagnosed with SLE. He also gave me a six week course of oral steroids. This worked and cleared the rash up. I’d also had this type of rash around Easter this year and I’d had a gp appointment so asked him. He thought I was allergic to something and I said ‘Yes the sun’ 😂 . He asked what worked and I said steroids which they sure did. Last summer I had a the same thing with those 2 really hot days we’d had and again had steroids which worked. Regarding the dermatologist the nurse told me that after I come back from going away this weekend if the rash was still there I could give them a ring and they could arrange to see a dermatologist or I could ring my drs and see them to referred nearer home if they think I need to.

When I was first diagnosed with SLE every test I had done was normal, blood tests, ecg, scans, X-rays etc and the last thing they did was a skin biopsy on the back of my neck which showed lupus. So I know definitely this is a lupus rash and need to be referred to a dermatologist and maybe more steroids 😞 not so happy about that but if they help I’ll have to have them.

I’ve also a gps appointment next Friday for him to have a look at.

Take care

[LuluM25 in reply to elizabeth-57]

I hope I helped. As you've had a biopsy you do know the rash is lupus related. Another reason to have it specifically treated and gone is of course that lupus is usually systemic and the inflammation travels around your body. After my experience I'm worried for you that it will get much worse so fingers crossed the treatment you've already had has at least slowed it or contained it. 🤞🏻🤞🏻

[michaellasmith Administrator]

Hi elizabeth-57,

It looks like you have had some great advice already, anything I would have advised has been covered. I agree that you should mention this (and any other new or worsening symptoms) at your appointment tomorrow.

Let us know how you get on.

Warm regards,

Michaella