Malar and/or rosacea?

[Wispymisty]

Hi everyone I wondered whether any members here have both rosacea and a malar flush on their faces?

I have a constant red flush across my cheeks but when I'm tired or stressed I get a flare up of rosacea on top. And as I'm really exhausted most the time at the moment they're both evident.

Obviously in the past when I've been to see the GP I've been under the weather so the rosacea is prominent. One GP who did think I had Sjogrens and possibly Lupus discounted my facial symptoms as there were papules visible.

I'll add a couple of photos below although they're probably not the clearest, but just wondered if anyone had both and if it had impacted on getting a diagnosis?

Thanks in advance

[Wispymisty]

In this I've tried to show that the flush extends beyond the papules but it doesn't show as clearly as it does in the mirror.

Close up of cheek to show rash

[GottaAsk]

My first blood tests were ran thanks to a photo of my malar on the cheeks. The immunologist saw the photo and immediately said "thats a lupus malar due to no papules and it sparing the nasal folds all the way down." But strangely now after a couple years and being treated for UCTD (lupus symptoms but scleroderma blood work), I do believe I am having Rosacea here and there. I do not have the lupus malar at all since being on the meds and treatment. I am pretty much out of flares too. But I do have now more and more little broken blood vessels on my cheeks and get flushed here and there. Same place as my lupus malar was. I was told by some other lupus patients they have both. So I think you are probably the same depending. The one thing that will make your doctor believe Rosacea too, is the fact the chin has some spots on it and is red. Lupus rarely touches below the nasal fold nor up in eye brow regions. Its specifically only on the cheeks and nose (I was told). I am not a doctor but just from experience spreading what they told me.

[Wispymisty in reply to GottaAsk]

Thanks GottaAskIt's interesting that you now get rosacea (or something similar) in the same places as your malar rash was.

For me the rosacea does sometimes respond to cream so I think I need to spend a week or two trying to really calm it down and then take more photos of the flushing underneath it. The flushing itself does stay to just my cheeks and bridge of my nose, but not the folds.

I think I need to build up a portfolio of photos of my different symptoms as they happen as with my luck any appointment I eventually get will be the only week I look relatively normal!!

Thanks again

[bhuebhek]

Have you seek advice from dermatologist about the rash? Dermatologist who is specialized in pathological diseases would be more competent to give diagnosis than GP. Once a GP told me that he only had 5 minutes lecture about Lupus in his whole years of medical study…

Last effort would be to get biopsy from your skin

[Wispymisty in reply to bhuebhek]

Thanks for your reply bhuebhek

A 5 minute lecture?! That's just dreadful!

I've struggled to get referred anywhere to be honest- other than contracted out CBT courses or pain clinic. I had a massive gastric flare around 10 years ago which did get me to see a gastroenterologist. He was the one that pushed for me to have b12 and vit D tests and told my gp to refer me to rheumatology- I hadn't done much research at that time and my fibromyalgia diagnosis had me in and out like a revolving door!!

The pain clinics are the ones who have now pushed my GP to do a full inflammatory screen (well hopefully a full one) and I'm trying to make sure I've enough info to get to see the right consultant with the results, even if I have to go private for the first appointment.

Thanks again

[stiff19 in reply to Wispymisty]

so sorry yes a fibro diagnosis is something you dont want on your record (as I do) even if you do have as yes its like a revolving door.When I had to go to a and e for chest pains and spoke to nurse she told me not to mention fibro if they asked 😩🤷‍♀️ for that reason.

a GOOD dermatologist should help 🤞best wishes

[Wispymisty in reply to stiff19]

Yes, as useful as my fibro diagnosis felt at the time, I definitely feel its slammed a few doors shut for me.A few people have mentioned getting a dermatologist to take a look- I think this is something I will have to explore

Thanks 🙂

[stiff19 in reply to Wispymisty]

Hopefully it will help to see one , just helpful answers and maybe some treatment to help once you know what it is. If rocascea maybe a different cream may help . Best of luck 🤞

[Wispymisty in reply to stiff19]

Thank you 😊

[soul22]

Hi nice to meet you 😊

I have both the lupus reaction to sun before knew I had it and before wore sunblock

I developed damaged veins capillaries which rosecra formed on.

Lupus butterfly rash on cheeks spares nasal folds

Hope helps take care

[Wispymisty in reply to soul22]

Thank you soul22 that dies help, as I know I had a lot of sun damage when I was younger. As well as a facial reaction to sun my arms flush and go itchy nowadays. I struggle with most creams - even those for sensitive skin - so struggle to find a good sun block to use and usually just end up keeping covered up as best as possible.

Thanks again

[soul22 in reply to Wispymisty]

You're welcome I'm using Hawaiian silk sun protection factor 50 it's lush no reaction no stained clothes.I got off Amazon I used have sunsense prescribed but not available since lockdowns.

Nivea uvistat GP prescribes to thick arthritis hands can't spread or get out of tune.

Loving hawian sick sun protection one off Amazon

[shrop]

My face looked like yours. My doctor treated me for rosacea initially. After suffering for weeks I asked to be referred to a specialist dermatologist privately. After blood tests I was diagnosed with Lupus. My face lost its hot red bloom but I still retain a rash and the odd spot. I keep out of the sun. I do get lethargic and go into a brain fog. I've had it 10 years now . All the best

[Wispymisty in reply to shrop]

Thanks shrop good to hear you got your answers. It seems wrong of me to be hoping for positive blood results but I've been getting so much worse over the last few years I just need to know for sure now,I'd not even thought about seeing a dermatologist until it's been mentioned today - it might be something I need to look into.

Thanks again

[Mya12king]

I had a rash very similar to yours and was told by my doctor it was Rosachea and given medication.2 weeks later I went back to the doctors for something entirely different and it was a young locum I saw who straight away said, thats not Rosachea, that's a malar rash / lupus and referred me to a rheumatology who confirmed his diagnosis with blood tests.

The dermatologist told me that the meds wouldn't have been doing me any good at all.

I am thankful everyday for that young man picking up on it.

That was 20 years ago and I have been stable on immunosuppressive for the past

18 years.

I hope you are able to get a blood test to be sure - keep insisting. Good luck x

[Wispymisty in reply to Mya12king]

Thanks for your reply 🙂 I'm currently using a metronidazole cream on my face and it does seem to help the rosacea element but the flush stays underneath. I'm hoping if the spots clear enough I can get a good photo of the redness underneath to show it's separate to the spots 🤞 I know there's more going on but it's getting listened to that's the problem.

You were definitely blessed that your rash was picked up on the way it was 🙂