Other names: butterfly rash; lupus war paint
But then there are the attention whores of the autoimmune world. The butterfly rash is the most obvious, because, just like Paris Hilton or Amy Winehouse, they're bitchy, flashy, and they request, nay, demand that they be in your face all the time. The rash can range from the "blushing" look to bearing a familial resemblance to Seal (whose scarred cheeks are, in fact, a malar rash). Sometimes your cheekbones and the bridge of your nose are just a little flushed, like your lupus slapped you across the face, and for other people it's a scarifying, face-munching wreck.
Yes, your disease really is this annoying.
When somebody sees the malar rash, they automatically assume that lupus is involved, kind of like assuming Don King is around whenever there's a boxing scandal. You know, like those commercials they've been running on TV recently: a woman looks in the mirror at her oh-so-obvious blush over the bridge of her nose and down her cheekbones, and the television asks in a hushed, pensive voice-over, "could I have lupus?"
Well, it's not so simple because, as it turns out, not everybody's autoimmune disease is an attention slut. Only 45-65% of people ever develop the facial rash as an indication of SLE. That leaves up to half of us without a blush on our cheeks and a visual cue for our distress. On the other hand, just because you look like you've been stung in the face by a swarm of paper wasps doesn't mean you have lupus, either. There are a whole host of inflammation disorders, infections and whatnot that can also give you a red nose and shiny cheeks-- dermatomyositis, a tinea or streptococcal infection of the skin, cellulitis, or plain old acne. So, don't take out that life insurance policy just because you've gone patchy in all the right spots. Nothing with SLE is ever that simple.
Unless you have skin involvement with your lupus, you may or may not ever find yourself daubed in lupus war paint. I'm still rash-free on my face; I have problems with bruising instead. That's my autoimmune disorder's plaintive, whiny, attention-whore cry for attention. That malar rash may be the one sure-fire sign your doctor is looking for, so don't be fooled that you don't have lupus if you've never had a rash. Instead, it could be that your SLE is much more sedate, and discreet, than having Paris Hilton splashed over your face like a magazine centerfold.
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