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Differential Diagnosis for Ana Negative with Butterfly Appearance

  • Single most likely diagnosis
    • Systemic Lupus Erythematosus (SLE): Although Ana is negative, the presence of a butterfly-shaped rash is highly suggestive of SLE. The negative Ana result does not rule out SLE, as some patients may have a negative test, especially early in the disease.
  • Other Likely diagnoses
    • Dermatomyositis: This condition can cause a similar butterfly-shaped rash, as well as muscle weakness.
    • Sjögren's syndrome: Although less common in teenagers, Sjögren's can cause a variety of skin rashes, including a butterfly-shaped one.
    • Rosacea: This condition can cause a butterfly-shaped rash on the face, but it is typically accompanied by other symptoms such as acne and flushing.
  • Do Not Miss (ddxs that may not be likely, but would be deadly if missed.)
    • Sarcoidosis: This condition can cause a variety of skin rashes, including a butterfly-shaped one, and can be life-threatening if left untreated.
    • Lymphoma: Some types of lymphoma can cause skin rashes, including a butterfly-shaped one, and require prompt treatment.
  • Rare diagnoses
    • Relapsing polychondritis: This condition can cause a variety of skin rashes, including a butterfly-shaped one, and is often accompanied by other symptoms such as joint pain and eye inflammation.
    • Mixed connective tissue disease: This condition can cause a variety of symptoms, including a butterfly-shaped rash, and is often accompanied by other symptoms such as muscle weakness and joint pain.

Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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