What is the cause of a seasonal, butterfly-shaped rash on the face, also known as a malar rash?

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Differential Diagnosis for Scary, Butterfly Rash Seasonally on Face

  • Single most likely diagnosis
    • Systemic Lupus Erythematosus (SLE): This condition is known for its characteristic butterfly-shaped rash on the face, which can be exacerbated by sunlight, fitting the seasonal description. SLE is an autoimmune disease that can affect multiple systems in the body.
  • Other Likely diagnoses
    • Rosacea: A skin condition characterized by redness, acne-like symptoms, and sometimes a butterfly-shaped rash on the face. It can be triggered or worsened by sun exposure, among other factors.
    • Dermatomyositis: An inflammatory disease that affects the muscles and the skin, causing a distinctive rash that can appear on the face, among other areas. While not exclusively seasonal, sun exposure can exacerbate symptoms.
  • Do Not Miss (ddxs that may not be likely, but would be deadly if missed.)
    • Sarcoidosis: A condition where inflammatory cells form lumps known as granulomas in various parts of the body, including the skin. It can cause a rash on the face and, while less common, is critical to diagnose due to its potential to affect vital organs.
    • Erythema Multiforme: A skin condition characterized by target lesions, which can sometimes appear as a butterfly rash on the face. It can be triggered by infections or medications and, in severe forms, can be life-threatening.
  • Rare diagnoses
    • Sjögren's Syndrome: An autoimmune disorder that primarily affects the glands that produce tears and saliva, but can also cause skin rashes, including on the face. While less common, it's a consideration in patients with systemic symptoms.
    • Polymorphous Light Eruption (PMLE): A skin condition that occurs in response to sunlight, causing a rash. It's one of the most common skin conditions related to sunlight but is less likely to present as a butterfly rash specifically.

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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