What is your medical diagnosis for this case Add you diagnosis as a comment below I will add the right answer as a comment too You can write differential diagnosis
D/D may be allergy just because of sun.. SLE can be, SLE, and eczema else i don't remamber now.. haha
SLE butterfly rash vs photodermatitis, because this rash avoids the periorbital region.. Less probably allergy or contact dermatitis (for instance due to a cream)
Differentials of Butterfly rash on face / malar erythema Common things first - is this somebody who flushes easily, either by getting embarassed easily (in which case it is called blushing) or becos of a greater number of superficial capillaries. - people living in higher altitudes ( higher RBC count, to make up for the lower atm. O2 ) - has the patient been out in the sun - seborrhea ( esp. with the multitude of face-washes available, people end up overdoing it, which leads to an increasingly dry skin to which the body reacts with some inflammation and sebum ) - rosacea - early mask of pregnancy - and of course lupus
IMO this is SLE Of course, upon taking history, you may be able to gain a better insight into the condition, but it will be interesting if some seniors can shed light on their diagnosis (only visually speaking), and how they came to that conclusion. I have always asked myself how to differentiate a "butterfly" rash considering there are many causes. In my quests, my only differentiations are: Favours acne rosacea if: - Rhinophyma present - If the philtrum is also affected - Possibly older patient Favours SLE if: - If the philtrum is unaffected - Scarring present Favours perioral dermatitis: - Chin & mouth affected - Young female (Unlikely) favours acne vulgaris: - Comedones/blackheads etc As mentioned, there should be more concrete differences, at least when looking at this visually. This is, after all, Spot Diagnosis
