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malar rash (butterfly rash)
Butterfly shaped rash on face (maxillary nerve distribution)
Etiology:
- 46-65% of patients with systemic lupus erythematosus
Clinical manifestations:
- red or purplish & mildly scaly rash
- shape of a butterfly
- involves the bridge of the nose
- spares the nasolabial folds of the face & areas beneath the nose & lower lip
* images [3]
Laboratory:
- antinuclear antibody (ANA) & further testing for systemic lupus erythematosus if positive
Differential diagnosis:
- disorders not sparing nasolabial folds
- rosacea (facial flushing that flares with strong emotion, hot drinks)
- dermatomyositis (heliotrope rash, Grotton's papules)
- erythema infectiosum due to parvovirus B19 infection (slapped cheek rash)
- erysipelas may spare nasolabial folds
- sharply demarcated erythema may be at the border of the nasolabial folds
- fever, chills, malaise, male
Related
malar
General
rash
References
- Medical Knowledge Self Assessment Program (MKSAP) 14,
American College of Physicians, Philadelphia 2006
- Wikipedia: Malar rash
http://en.wikipedia.org/wiki/Malar_rash
- Goglin SE, Margaretten ME
Images in Clinical Medicine: Malar Rash
N Engl J Med 2021; 385:164. July 8
PMID: 34233099
https://www.nejm.org/doi/full/10.1056/NEJMicm2029589