What is the cause of a malar rash (butterfly-shaped rash) on the face?

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Differential Diagnosis for Butterfly Rash on Face

  • Single most likely diagnosis
    • Systemic Lupus Erythematosus (SLE): This is the most common condition associated with a butterfly-shaped rash on the face, typically spanning across the cheeks and nose. The rash is often accompanied by other symptoms such as joint pain, fever, and fatigue.
  • Other Likely diagnoses
    • Rosacea: A chronic skin condition characterized by inflammation, redness, and acne-like symptoms on the face, which can sometimes resemble a butterfly distribution.
    • Dermatomyositis: An inflammatory disease affecting the skin and muscles, which can cause a rash on the face, including the cheeks and nose, though it's less typical than SLE.
    • Sjögren's Syndrome: An autoimmune disorder that can cause skin rashes, including a butterfly-shaped rash, though it's more commonly associated with dry eyes and mouth.
  • Do Not Miss (ddxs that may not be likely, but would be deadly if missed.)
    • Lyme Disease: Although less common, Lyme disease can cause a rash that might be mistaken for a butterfly rash, and missing this diagnosis could lead to serious complications if not treated promptly.
    • Sarcoidosis: A condition that can cause skin rashes, including on the face, and can be life-threatening if it affects vital organs and is not diagnosed and treated.
  • Rare diagnoses
    • Erythema Multiforme: A skin condition characterized by target-shaped lesions, which can occasionally appear as a butterfly rash on the face, though it's rare and usually associated with other symptoms.
    • Pemphigus: A group of rare skin disorders that cause blistering of the skin and mucous membranes, which can very rarely present with a butterfly-like rash on the face.

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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