Lupus? | Arthritis Information

Hey all. I've been diagnosed with sero-positive RA since December/2006. I'm currently taking Methotrexate, Folic Acid and Plaquenil to control the RA. Starting in January of 2008 I began to notice a light red "mask" on my face that starts about midline just outside the corners of my eyes on the outer part of my face and swoops down below my eyes and then back up across the bride of my nose. This red area (mask) is sometimes very faint and other times it is bright red and very noticable. It is especially bad after I've been out in the sun and or have gotten overheated. It aggrivates me because I look like a raccoon....lol. The red area is not raised up like a common rash, it is just more like a red sunburn in appearance. The thing is, this all started in the dead of winter. I live in the midwest (Illinois) and I had not been out in the sun at all. I can not go out of the house for a week and the "mask" is still there so it's definately not due to sunlight. Also, it is extremely pronounced after getting out of a hot shower. I hadn't though much about it for a while as I thought that it might be due to one of my medications. It didn't occur to me that it might be a "Lupus" mask until one of my wifes friends who has lupus asked if I had Lupus. When I inquired as to why she asked she mentioned the "mask" on my face. Does this sound like a lupus mask?

I go back to see my Rheumatologist in (3) weeks. From what I understand Lupus is treated with the same medications as RA so I don't beleive there is any rush to find out. However, I plan to discuss this with him at my next visit. However, I wanted an opinion from others who do have a confirmed lupus mask.

Regards,

Ryan (Ta2d)

Ta2d2008-06-17 07:19:15I've had a lupus-type "mask" several times over the past few years, but since it came and went after only a couple hours, I wasn't sure it meant anything. But after more tests last month, I have been confirmed to have Lupus as well as the RA I've had for years. I suspected as much since my symptoms include low-grade fevers, skin rashes, headaches, extreme fatigue, swollen ankles, depression, in addition to all my RA symptoms.

Since I also have antiphospholipid syndrome (blood clots which have caused lesions in my brain), my rheumatologist's recommended treatment is Rituximab. It's for both RA and Lupus, I believe, but specifically targets the antiphospholipid syndrome, but with no guarantees of course :-(

I had 2 infusions in November but they didn't seem to do much. However, I went through an extremely stressful period starting in December, with the death of my dear sister and my own MRSA infection following Achilles rupture surgery, so those events may have negated any positive effect. And I have been unable to take methotrexate because of the MRSA. Anyway, we are doing the infusions again, beginning in two weeks. I'll report back here if there is any response to the treatment.

I try to be hopeful, but it is not easy. I desperately need THR as I am pretty badly crippled by avascular necrosis in my right hip, but surgery has been postponed indefinitely because of all these treatments and, of course, the MRSA.

Cat E. Clysm2008-06-19 17:33:52Cat,

Thanks for your reply and for the info. Sorry to hear about the rough time your having. Again, my daughter first noticed the "mask" in January of this year. Since then I always have the "mask". However, sometimes it is very faint, like a light blush or very light sunburn. Other times it is bright red and I look like a raccoon. I'm definately going to mention it to my Rheumy when I see him in two weeks. As far as I know, I've never been tested for Lupus.

Ryan (Ta2d)

Hi Ryan!

I have had RA since 4/07 - and just found out about 2 weeks ago that I have SLE Lupus. I am taking the same meds as you are and was also sero-negative RA. Now that I have a new diagnosis - my rheumy is keeping me on the same meds (for now). I do not have the butterly rash on my face - but as soon as I get in the sun - I get a red rash across my chest and neck (it is not raised). I have been a sun bug all my life - so this is kind of devastating to me. I went to Key West in June for vacation - broke out in small bumpy rash covering my upper torso - running to the tips of my fingers - and my lower lip was swollen for 2 days. I saw my rheumy when I came home - she wanted lupus bloodwork immediately - and I now test positive for SSA and RPN antibodies (I didnt one year ago) - and a positive ANA - and the sun sensitivity - rheumy said I have lupus.

I would definitley mention this to your rheumy. While the medication for Lupus may stay the same for you - lupus in males can have more problems - and it's definitely worth getting checked out. Also - if you do test for lupus - the sun could be a problem. Now I have to avoid it - or wear heavy sunscreen - as I found it is a trigger for me. Fortunately for me my rheumy thinks I have a mild case of Lupus. She actually said I have "Rupus" - which is rheumatoid from the lupus. I hope you find the answers you are looking for - keep us posted.

Hugs

~Brenna

Brenna,

Thanks for the reply. I mentioned my butterfly rash to my Rheumy at my last appointment. It was his opinion that I'm just light sensitive and that I should cover up in the sun. However, this can't be the case. The reason that I say this is that I was just on a two week vacation from work. During this period I was doing some inside work and I only set foot outside (3) times. That said, I'd have occasions duruing this period where I'd look fine 3 or 4 hours and then the Malar type rash would develop and stay until one or two days later. Again, I never set foot outside in the sun that day so I don't see how the malar rash can be attributed to sun. Especially since our house is in heavy shade due to trees and we have blinds in our windows.

I go back to see my Rheumy today and I'm going to bring the issue up once more. I don't want to borrow trouble but I've also read that there is a whole other side of issues to deal with when you have lupus such as organ damage, etc.,. I'm sero-positive RA so if I were to have Lupus also I would have two separate conditions.

How do they confirm a diagnosis of lupus is you already have RA?

To strengthen the possibility that I could also have lupus I've just read that "low platelet" count is extremely common as an effect of SLE. I've consistantly shown a low platelet count during my past (3) labs.

Ryan

Ta2d2009-07-07 11:08:29I saw my Rheumy yesterday afternoon and I brought up the Malar rash once again that appears on my face and comes and goes without warning but almost always appears during a flare. My wife and I stressed the fact to him that I can not leave the house for 3 or 4 days and that the rash will still show up. Our house is heavily shaded and we have blinds on our windows so its definately not simply due to light sensitivity. My rheumy made note that over the past (6) months I've presented with a fluctuating and consistantly low platelet count. This combined with what appears to be a malar rash on my face has encouraged him to order an "ANA" test to check for lupus. This was the only test he ordered and he stated that if the test came back positive he would send me for more lupus related tests.

I've already been diagnosed with seropositive RA so does this mean that I would have lupus in conjunction with RA or would it mean that I was misdiagnosed with RA and that I only have lupus?