Q. Why is there a red rash spreading over my cheeks and the bridge of my nose?

Answered by
Dr. Sumit Srivastava
and medically reviewed by iCliniq medical review team.
This is a premium question & answer published on Nov 29, 2018

Hi doctor,

I am a 15-year-old female. I weigh 130 pounds and am 5 feet 2 inches tall. I have recently had a red rash that is spread over my cheeks and the bridge of my nose. It has very clean margins and looks a lot like the malar (butterfly) rash that goes along with lupus. However, the blood test that my doctor ordered for lupus came back negative so I am wondering what this could be. I have had two episodes of this rash, the first of which happened about a month ago and lasted for about five days to a week, and a little over a week ago the rash came back. It stings and has gotten dry and somewhat stiff. Though the rash itself is somewhat similar to the ones associated with rosacea and eczema, I do not have any of the symptoms expected with the two conditions. In addition to the rash I have also been having stomach issues which include nausea, vomiting, and a generally upset stomach. On to of these symptoms I am also experiencing fatigue, soreness in my joints, what I believe is Raynaud's phenomenon in my toes. I have also experienced slight dizziness so often upon standing up.


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Dr. Sumit Srivastava

General Medicine Internal Medicine


Welcome to icliniq.com.

It looks like the rash one has from lupus (attachment removed to protect patient identity). But you are tested negative for it. Considering your other symptoms it is auto-immune in origin. Other causes could be drug-induced malar rash, polymyositis, rheumatoid arthritis, and scleroderma. In autoimmune diseases, there is a formation of antibodies against your own body substances and cells. It does not have any specific cause. The cause is multifactorial, genetic, environmental, etc. It affects almost all organs in the body.

You have to do the following investigations to find the involvement of the particular systems. Complete blood count, ECG, and echo, urinalysis, X-ray chest, blood urea and creatinine, ESR, CRP, liver function test. If the abnormalities are present in any of the above tests, finally we have to do the antinuclear antibody titers, ENA profile, anti-ds DNA antibody, complement levels C3 and C4. NSAIDS, Hydroquinone, and Methotrexate, etc., are commonly used for the treatment of autoimmune diseases. Nowadays plenty of monoclonal antibody treatments are available. It cannot be cured. You can reduce the severity of the disease and avoid experiencing the symptoms.

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