Malar rash

[Vicki]

Hi everyone. I’m new here but I’ve been researching my illness even before I saw the doctor. I’ve had symptoms for years, but thought it was just the natural aging process. My doctor diagnosed me with RA but I’ve had this red face since at least 2009. When I asked my rheumatologist about it in february he told me it was from too much sun. Really? Of course I informed him that it was february and I haven’t been outside. But I understand the rash is a symptom of Lupus. Does anyone else with RA have this rash? I’m wondering if I’ve been misdiagnosed, yet my RF is 196, ANA postiive and speckled pattern, anti-ccp >250. It is my understanding that the anti-ccp is a 98% marker for RA. My GP thought it odd that my sed rate was normal, as was my c-reactive protein. I’m trying to find an AP doc that is knowledgeable but the closest I’m going to get is a 2 hr drive. My rheumatologist is out of the question because I already know the answer, and I don’t trust him, so maybe I’ll see if I can convince my GP to do it. But I’d like to be sure we’re treating the right infectios agent, and I”m not even sure what I have. Any comments or experiences are welcome.

Rheumatoid Arthritis
+ANA (1:160,speckled), RF 196, CCP>250, Lyme Negative, CRP & Sed Rate normal
Methotrexate, Prednisone, Ibuprofen, Folic Acid, Magnesium, Multivitamin, Vitamin C and D

[jims]

Hello vclawson. I think one can have the malar rash from other causes than lupus. I had such a rash during a time when my immune system was devastated from Remicade. My oldest sister revealed to me she has had such a rash for 2 years, yet she feels otherwise good. It is good your inflammation markers are low, looks like you already know about keeping your gut healthy. I am not a regular poster but daily reader for several years. I trust others will chime in with questions to help guide you. jims

[Vicki]

Thanks for the reply jims. My sister too had a rash for years; we thought it rosacea. It seemed to go away on it’s own after she divorced her husband. I think it was stress related in her case.

Rheumatoid Arthritis
+ANA (1:160,speckled), RF 196, CCP>250, Lyme Negative, CRP & Sed Rate normal
Methotrexate, Prednisone, Ibuprofen, Folic Acid, Magnesium, Multivitamin, Vitamin C and D

[BG]

One can have both RA and lupus and or other connective tissue diseases. Because you have a positive ANA, speckled pattern, plus a malar rash, I would suspicious for SLE and or dermatomyositis in addition to RA. Rosacea and other skin conditions can cause a malar rash as well so various blood tests and or skin biopsies are needed to help clarify the diagnosis. It sounds like your rheumatologist has done many, if not all, of the correct blood tests so I would seek a consult with a dermatologist to rule out other causes of the malar rash and help confirm the diagnosis of whatever is causing the rash. Chronic skin infections can cause a malar rash too (staph, strep, etc.) so consulting with a dermatologist is the only way of trying to sort that out as well.

Your rheumatologist seems dismissive so you might want to seek a second opinion from another rheumatologist at some point.

Inflammatory markers (ESR and or CRP) can fluctuate a great deal and be normal sometimes and high other times, especially during a flare.

Hope this helps,
Barb

[BG]

Something I forgot to mention: Minocycline is a DMARD used to treat RA so you can ask your rheumatologist or GP to prescribe it for that reason. Because you’re concerned you might have lupus, you can ask that doxycycline be prescribed as an alternative to minocycline.

If a physician diagnoses you with rosacea, you can ask to be precribed minocycline or doxycycline for that reason. If your malar rash clears up after taking mino or doxy, then you most likely had rosacea or a skin infection that caused your malar rash because the malar rash of lupus and or dermatomyositis never goes away permanently — it waxes and wanes or comes and goes but never stays gone.

Barb

[Parisa]

All of these autoimmune diseases can overlap so you can have RA and scleroderma, dermatomyositis and RA, etc. etc.

The malar rash can go away if you can get to the cause. For my husband it took treatment for Lyme and Babesiosis.

[Vicki]

Thanks forthe good information Barb and Parisa! And Barb, you are correct; my Rheumatologist is most certainly dismissive. He works on a “need to know” basis; and he only tells me what HE thinks I need to know. It’s not working so well for me. There are only two Rheumatology offices here in the area where I live. And they like their traditional treatments. The other office I was referred to first but they couldn’t even get me in until May and my doctor contacted them in November 2011 for the appt. So I asked him to refer me to someone else, and I’m sorry I did. I want to hurry and find a docto that will do AP as I never started the Plaquenil and I’m my Rx for NSAID expires soon.

So if anyone has experience or knows someone that has experience with any physicians practicing AP in the northern Virginia, Maryland, or southern Pennsylvania areas, I would love to hear from you. Thanks for all your help!

Vicki

Rheumatoid Arthritis
+ANA (1:160,speckled), RF 196, CCP>250, Lyme Negative, CRP & Sed Rate normal
Methotrexate, Prednisone, Ibuprofen, Folic Acid, Magnesium, Multivitamin, Vitamin C and D

[jltntl]

My daughter had malar rash and high ANA speckled and was dxd with SLE but turns out it Lyme Disease. LD can also cause a malar rash.

[jltntl]

I see I needed to update my signature re my daughter!

[Vicki]

Update: I did see a dermatologist and he told me it was not the bacterial rosacea, but inflamed blood vessels. But thanks to all that responded.

Rheumatoid Arthritis
+ANA (1:160,speckled), RF 196, CCP>250, Lyme Negative, CRP & Sed Rate normal
Methotrexate, Prednisone, Ibuprofen, Folic Acid, Magnesium, Multivitamin, Vitamin C and D

[Author]

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