Malar rash??

[MokeyRed4]

Hello everyone! I am wondering if you all could share your thoughts on this: I have been diagnosed with undifferentiated connective tissue disease based on a positive ANA (has ranged between 1:40 – 1:640), positive SSA, fatigue, photosensitivity, hair loss, mild anemia and a family history of lupus (my mom). I am on 200mg of Plaquenil and have been since summer of 2004.
I am now noticing a faint, speckled blush on both cheeks right below my eyes. This has corresponded with an increase in fatigue and increase in hair loss. The problem (well, it’s not a problem…hahaha) is that I’m also 5 months pregnant, and I know that “pregnancy blush,” fatigue and hair loss can all be attributed to pregnancy. So I’m not sure what to do about this new blush on my cheeks. Do I go to my rheumatologist and have her look at it? Or do I just chalk it up to pregnancy? Admittedly, it’s not much to look at…just a mild blush…I’m just not sure what to do. I did have my routine bloodwork done a month ago, and my ANA was 1:160, SSA was still positive, but ds-dna was negative (as it always has been), so at least at that point there was no major change in my bloodwork. I’d really appreciate your thoughts on this…I hate to run to the doctor with every tiny symptom that pops up…but this seems a little suspicious to me.
Thanks!
Kate

[cath]

Hi Kate,

Welcome to the forum.

And congratulations on your pregnancy8) .

Even though it was only a month ago you were at the rheumy's, it is probably worth the effort of getting it checked out. if it is a sign of a flare, the sooner it is dealt with the better for you and baby. They may want to check your complement levels to look for evidence of flaring maybe...

Chloasma - the mask of pregnancy is more often brownish than red - it looks like a mild sun tan. Whichever it is, staying out of sunlight and wering a high SPF sunscreen is a good idea.

All the best, and I hope things go well for you:p

X C X

[sadieone]

I agree with Cath.
It never hurts to call and let them know ofyour symptoms,, If they need to see you to evaluate further than they will schedule an appt.

For the sake of the child i would not be embarrased if i had to call every day.

Take Care and
Good Luck

[Maia]

If it's more red than brown, it's more likely a lupus facial rash. You can also take a picture of it if you don't want to go to the doctor again so soon & e-mail it to him. If you had regular bloodwork done, then hopefully they already did the complement levels to check for an increase in disease activity.

How often are you having your bloodwork done now? I understand the leeriness of contacting a doctor already, but you are the best judge of whether to call or not. Many doctors will attribute a lot of things to pregnancy instead of to lupus though!

FOr me... The increase in fatigue in month 5 is actually a little suspicious, because most women experience a decrease in fatigue in the 2nd trimester after a fatigue filled first trimester. Then of course the fatigue returns later in pregnancy. Also, hair loss isn't supposed to occur until after you have the baby. So that actually seems like a sign of increased lupuus activity.

The real question is, are you feeling bad enough to go on prednisone or increase your dose of Plaquenil to 400 mg a day (the usual dose). Those are the two most normal courses of action that would be taken for someone in your position.

[donna brain]

i never thoght of taking a photo what a great idea in the past i have made appts to show rashes only for the rash to disappear before the appt

[MokeyRed4]

Thank you all for your responses. Maia, that's exactly it. Even if stuff is stirred up a bit right now...I don't feel too terrible and I really don't want to increase my Plaquenil. I decided to wait until Monday and if it isn't gone I will call my doctor. Funny you mention that pregnant women usually feel good in the second trimester...I had felt GREAT until about a week ago...I slept 11 hours last night and can still barely stay awake today. My hair has also not shed AT ALL for months, and now all the sudden it is falling out and I lost about half of my eyebrows too (I have had my thyroid checked a hundred times...it seems like for me this is related to autoimmune activity). Feels like something is going on to me...I will keep a close eye on it for the next few days and then call my doctor.

Thank you all!
Sara

[MichelleAnn]

I have a question to add to this post....does most Lupies Butterfly rash come and go? Mine comes and goes and when in a severe flareup it is more there than not on my cheeks??...is that normal? Some doctors seem to think it should stay all the time is the impression I got??...
M

[Clare.T]

Hello Michelle

It does not have to be there all the time.

:)

Hugs
Clare