Your skin is your body’s largest organ, and while many of us focus on keeping it looking youthful and wrinkle-free, it could also be a vehicle through which other parts of your body signal that an illness or disease is brewing. Sudden onset of blistering, scaliness, discoloration, or a rash could point to an autoimmune condition, an allergy, a virus, or even heart disease. And if you notice a particular rash in one area in particular, it may be time to reach out to a doctor for some bloodwork. Read on to find out more about the unique facial rash that’s often misdiagnosed.
If you notice a red rash across your cheeks and the bridge of your nose, it could be a malar rash. Also known as a butterfly rash, according to the Mayo Clinic, this skin condition is often red, pink, or purple, and can appear as blotchy, scaly, smooth, or raised. While the butterfly rash may come and go within a period of days or weeks, it can be a symptom of a wide-range of underlying health problems, including lupus.
As Maryann Mikhail, MD, writes for GoodRx, the rash is actually considered a telltale sign of lupus. In fact, about 50 percent of all lupus patients develop a butterfly rash, according to Johns Hopkins Lupus Center.
Lupus is a complicated autoimmune disease that affects people’s skin in addition to their kidneys, brain, heart, lungs, and joints. According to the Mayo Clinic, other symptoms of lupus include fatigue, hair loss, sensitivity to light, dry eyes, brain fog, and joint pain.
The butterfly rash is also a common sign of rosacea, a bacterial infection called cellulitis, and lyme disease, among other conditions, Healthline explains. It can also mimic sunburn.
Therefore, it’s entirely possible for you to dismiss it or for your doctor to mistake it, especially for rosacea. “While a rosacea rash may look like lupus, the difference is that a lupus rash doesn’t have red bumps that are typical of rosacea, although the rash can be raised,” according to Everyday Health.
Since it can be easily confused for other conditions, if you notice this rash, ask your doctor to order a blood test to get to the root of the problem. They can look for antiphospholipid antibodies, antinuclear antibodies, or a low platelet count to see if it is lupus.
For more health tips sent straight to your inbox, sign up for our daily newsletter.
Lupus is regularly referred to as the great imitator. According to expert Marisa Zeppieri, an author with lupus who founded LupusChick, “symptoms come and go, and mimic many other diseases.” This often leads to misdiagnoses and inappropriate treatment plans. According to a 2016 LupusChick research study, the “average time span between initial symptoms and diagnosis [is] six years.”
According to Johns Hopkins Lupus Center, lupus affects roughly 1 in 2,000 people in the U.S. and 90 percent of them are women. Symptoms typically first appear between the ages of 10 and 30, but, like the butterfly rash, they can be easy to brush off.
“Lupus is not easy to diagnose because the signs can vary from person to person. The symptoms can even overlap with other disorders, which could lead to a misdiagnosis. Plus, there is no test that can diagnose lupus,” the experts at University of Utah Health explain. “If systemic lupus is suspected, we conduct blood and urine tests in addition to your physical examination to help diagnose you.”
Lupus is not a one-size-fits-all disease, which may contribute to the time it takes to reach an accurate diagnosis. No two cases of lupus are exactly alike. Plus, there are multiple forms of lupus, as Johns Hopkins Lupus Center explains. So knowing the specific diagnosis is key to defining each person’s individual treatment plan—which can range from blood thinners, steroids, and over-the-counter NSAIDS to chemotherapy, immunosuppressants, and even organ transplants.