Malar rash caused by heat?

[Nome11]

Hello, just wondering if this looks like a malar rash, and if so, can be triggered by heat as opposed to sunlight?

I'm suspected of having cutaneous lupus (awaiting further biopsy) but when I'm very hot e.g. out of the bath, in a warm building, my face will flush. I'm careful in the sun anyway - hats, shade and sunscreen so I don't know if it would come up with UV. I tested ANA negative when I went to GP for a possible chilblain (lifelong Raynaud's but it's definitely got worse in recent years). I've not managed to find whether malar rash is just in systemic lupus or can be in cutaneous lupus, not whether it can be brought on by heat instead of UV.

Sorry for the dreadful photo, it was poor light and I was in bed 🙈

[Chris21]

hi Nome, rashes are the most annoying things to have someone diagnose. i must be honest in that i have lots of quirky rashes that come and go and ive not actually been to see anyone, although i keep thinking i should.

i have diagnosis of lupus sle, sjogrens and pbc (main ones) before diagnosis i would come up in large hive type spots that were hideous, know one knew why. once diagnosed and on hydroxychloroquine theyve gone. i do have permanent red circles 🤷‍♀️ last few weeks my face has gone red with very small spots/bumps, it becomes worse when im hot and during the night i wake up scratching with the body hot, itchy and small spots. whether its lupus or pbc causing it 🤷‍♀️ ive been using lots of moisturiser which seems to help. my daughter has coeliac and also has same red rash on her face. she did ask rhuematologist what is was and he said, he didnt know best see dermatologist and we all know how long that will take.

the other rash im considering is roscera (not sure of spelling) but dont think its presenting as it should.

hope you find a solution to what is causing your ‘rosy’ cheeks 😊

[Nome11 in reply to Chris21]

Hi Chris, thanks so much for your reply; sorry to hear about your other illnesses as well as lupus. My nanna had PBC and I know the symptoms can be a lot to manage, I had obstetric cholestasis whilst pregnant and oh the itching! We have a history of autoimmune conditions going back to my great grandmother (but they've all been different).I hope you and your daughter find an answer to your rashes; I've got an appointment with dermatology in June so shall ask about mine then. Good luck!

[Quuen]

I had this same issue. It can be triggered by heat, stress, too much exposure to UV light. I was told initially that I only had discoid lupus even though my first inital appointment with the dermatologist she mentioned that I had a butterfly rash. I was scouring the Internet trying to work out the difference between DLE and SLE and all I kept reading was that the butterfly/malar rash is typical in SLE, no mention of it in DLE. After doing blood tests and my ANA results were negative, I was told I could not possibly have SLE and my butterfly rash has never been mentioned again. 9 months later I was diagnosed with SLE by the rheumatologist. One thing i do know is that you know your body and I've learnt in this process you really have to advocate for yourself. Hope I haven't scared you, and hope you get some answers soon!

[Nome11 in reply to Quuen]

Hi Quuen, thanks for your reply. Really interesting to hear the rash is not usually associated with DLE. Do you have any other SLE symptoms (if you don't mind answering) or are yours all skin based? My skin things are really small and not typical of cutaneous lupus, my initial biopsy brought back those results so it's all a bit unknown at the moment. I need another biopsy to confirm whether it is DLE. They're just small scaley patches on my eyebrow that are a bit sore and itchy, but don't heal - they've been there since at least Christmas 2022 when I first noticed them. GP and dermatologist were stumped by them 😅 I get the rash occasionally, heat and possibly UV are triggers, but I am really careful in the sun anyway. Thanks for your good wishes 🙂

[Brychni]

I've started getting what you've described. Tempted to say it's hormonal ( I'm 53) but it doesn't feel like it. It's not so much the cheeks going red, but just how red and how long they take to calm down: ages. Had weird things going on with my fingers lately, Raynaud's wise, and that's kind of what it feels like in the cheeks. Next rheumatology appointment is in May.

[Nome11 in reply to Brychni]

Thanks for your reply Brychni. I'm 37 so (hopefully!) mine isn't hormonal but who knows? My face feels very hot when I get it, uncomfortably so. Hope you get some answers at your next rheumatology appointment.