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Butterfly Rash (Malar Rash) - Pictures, Treatment, Symptoms, Causes

Updated on July 9, 2014

Butterfly Rash Pictures

What does "Butterfly Rash" mean?

Butterfly rash is also known as Malar rash and is described as a skin irritation that extends across the face in a butterfly appearance. The appearance is somewhat similar to a butterfly in a manner where the wings are covering the cheeks with the body of the butterfly is extending down the bridge of the nose. Butterfly rash is not a condition but rather a symptom of other underlying disease that may or may not be serious or life-threatening. It is a skin irritation that is often associated with the onset of a disease called Lupus.

A lupus is an autoimmune disease characterized by an inflammation of various tissues of the body. Individuals with lupus have an antibody that produces unusual antibodies in the blood that mistakenly ward off their own body tissue rather than the foreign objects. This condition is eight times more common in women than in men. Butterfly rash is the common symptom of this autoimmune disease as lupus can affect various organs and parts of the body including the skin thus, the onset of butterfly rash. Manifestation of skin symptoms is usual with lupus as the skin is typically involved in the process of the disease.


The onset of a butterfly rash is usually the result of tissue inflammation triggered by the erroneous attack of the immune system against its own tissue. The symptoms of butterfly may vary depending on the severity of lupus attack and other underlying condition that caused the onset. The symptoms can go mild and the butterfly rash may have periodic attacks followed by an improvement of the symptoms.

The malar rash can go from mild to severe depending on the extent and manner of exposure to the rays of the sun. The rash may be elevated or flushed under the skin. Mild malar rash has reddish blush-like appearance while the severe ones may have scales over the affected area on the face.

Malar rash is usually non-pruritic although it can be fleeting and progressive. There are cases however that butterfly rash may have a burning sensation although this is quite seldom. The rash can linger for weeks or may last for a month and leave behind a scar across the face or where the rash has developed. Malar rash can also occur in other parts of the body such as on the forehead, neck and chest in similar fashion.

The butterfly rash associated with lupus have pain and swelling and may also have stiffness in the joints. This is mainly the effect of lupus on the connective tissue of the skin triggered by an erroneous attack on the immune system. The onset of rash in lupus may also signify an inflammation of the glands or an infection in the kidneys or the urinary tract. These can result to butterfly rash associated with fever or an increase in the body temperature.

Butterfly rash can occur accompanied by other symptoms of lupus such as:

  • Sudden onset of high grade fever
  • Severe headache
  • Fatigue and general weakness
  • Muscle and joints swelling, stiffness and pain.
  • Onset of lesions or sores in the mouth and on the lips.
  • Nausea and vomiting

Butterfly rash may also be associated with other symptoms of lupus that can indicate a life-threatening condition such as:

  • Presence of blood in the urine
  • Chest pain and tightness
  • Difficulty in breathing or shortness of breath
  • Abdominal pain that is severe in degree
  • A sudden episode of seizure
  • Alteration in the level of consciousness.
  • Sudden change in behavior or mental status such as lethargy, delirium, hallucinations, delusions and confusion.
  • Sudden passing out or a state of unresponsiveness.
  • Decreased or absence of urine output in relation to the number of fluid intake and infusion.

These signs and symptoms are rather serious and potentially life-threatening that immediate medical attention and prompt medical treatment is necessary to prevent serious medical complications and to avoid irreversible damages possible with the onset of the underlying condition and not the butterfly rash itself.


The onset of malar rash can be implicated in various diseases and conditions that triggered the onset. Such conditions may include the following:

Systemic lupus erythematosus is a chronic disease of the immune system that leads to erroneous attack on cells and tissues of the body. It can attack different parts and organs of the body including the skin, thus the onset of butterfly rash. Systemic lupus erythematosus can affect people with ages of 15 to 50 years and is twice common in women than in men.

Bloom syndrome is a syndrome characterized by an aberration in the pattern of chromosomal arrangement. The syndrome can cause the development of a rash on the skin surface including the development of butterfly rash that extends across the face.

Pellagra is a disease that results from a deficiency in vitamins particularly vitamin B3. This can result to butterfly rash as its symptoms to manifest the onset of the disease.

Lyme disease is caused by Borrelua burgdorferi which is transmitted by an infected tick belonging to the group Ixodes. This condition can affect the musculoskeletal system, nervous system and the skin. The onset is manifested by a development of the skin rash or the butterfly rash.

Dermatomyositis is a disorder involving the connective tissue causing skin and muscular inflammation. The inflammation of the muscles and skin can lead to the development of butterfly rash.

Erysipelas can also cause painful lupus malar rash that resulted from an acute inflammation of the skin. The condition is caused by Streptococcal bacterial infection.


Butterfly rash is characterized by an onset of rash extending across the face. It is therefore necessary to consult a doctor prior to treatment as the facial skin is usually sensitive in nature. Treatment may be prescribed by the following:

Steroid creams and ointment application over the affected area will help reduce the inflammation.

Antimalarial drugs are now being used to treat lupus including the butterfly rash. This drug facilitates skin healing while protecting it from the effect of the sunlight or the rays of the sun.

Lifestyle can help protect the facial skin and prevent the onset of butterfly rash through the wearing of protective measures such as putting on sunscreen and wearing a wide brim hat to cover and protect the face from the harmful effects of the rays of the sun.


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