What Is a Lupus Butterfly Rash Like?

Reviewed on 4/5/2022
Illustration of a lupus butterfly rash on the cheeks and nose
A lupus butterfly rash (malar rash) covers the cheeks and nose, can happen suddenly or after sun exposure, usually appears red and raised, may be scaly, usually does not affect the nasal folds, or may occur on its own.

Lupus is a chronic autoimmune disease in which the body’s immune system mistakenly attacks its own organs and tissues, causing inflammation and pain, commonly in the skin, joints, and internal organs such as the heart and kidneys, though it can affect any part of the body. 

7 Lupus Butterfly Rash Symptoms & Signs

The lupus butterfly rash (malar rash): 

  • Covers the cheeks and nose and is shaped like a butterfly, which is why it is called a “butterfly rash” 
  • Can happen suddenly or after sun exposure
  • Usually appears red and raised
  • May be scaly
  • Usually does not affect the nasal folds
  • May occur on its own, but sometimes is an indicator of an oncoming flare-up
  • Affects about half of all patients who have lupus

Other symptoms of lupus may also include:

How Is Lupus Diagnosed?

In addition to a medical history and physical examination, tests used to help diagnose lupus or to rule out other conditions include:

  • Blood tests 
  • Protein electrophoresis
  • ANA 
  • Anti-double-stranded DNA (anti-dsDNA)
  • C3 and C4 or CH50 complement levels
  • Urine protein-to-creatinine ratio
  • Rheumatoid factor and anti-cyclic citrullinated peptide antibodies
  • Serologic studies for infection
  • Creatine kinase (CK)
  • Urine tests
  • Tissue or organ biopsies
  • Electrocardiography 
  • Tests to check for pulmonary embolism 
  • Diffusing capacity for carbon monoxide 
  • X-rays of swollen joints
  • Chest X-rays
  • Ultrasound 
  • Echocardiography 
  • Computed tomography (CT) scan 
  • Magnetic resonance imaging (MRI) scan

What Is the Treatment for Lupus?

Lupus is usually treated with medications to help manage symptoms, such as:

  • Anticoagulants 
  • Anti-inflammatories and steroids 
  • Antimalarials (to help protect skin from rashes and UV light)
  • Biologics 
  • Immunosuppressives 

Other steps to help patients manage symptoms of lupus include:

Reviewed on 4/5/2022
Image Source: Getty Images