Need a little feedback from observations, please

gr8rnpjt, RN · Jul 24, 2007

Dermatology is not my forte. So I'd like to know, from those of you that either have this condition, or have seen it and knew what you were looking at, how it compares in severity to the pictures that I seem to find in my books and online.
I'm talking about the butterfly rash that's characteristic of SLE, or Lupus. The pictures I can find look pretty horrible. As in, they seem to be dark, well defined sometimes, and disfiguring in a few cases. I've known a couple of people with it and never noticed anything like what I see in pictures. Has anyone known it to be subtle, not terribly well defined, like an overactive blush?

yes, I have seen it represented as what looked to me like a ruddy complexion, not very defined at all. There are some degrees of the disease. I had a good friend who was a nurse who had severe organ damage from the disease, but she had almost no rash at all. It depends on severity and type of involvement whether it be internal organs, or other areas. (sorry I don't know much but I know that sometimes there is not a rash) My friend had severe organ involvement and told me it started after she had surgery for breast implants. She was very involved several years ago with the whole silicone implant scare back in the mid 90's and had a multi million dollar lawsuit against the company that made her implants. We lost touch so I don't know the outcome, but she was the only person I knew personally who had Lupus.

neneRN, BSN, RN · Jul 24, 2007

There's a nurse I work with who is pregnant now; hers actually looks like a sunburn you would get while wearing sunglasses...the top part (just underneath the eyes) is very dilineated but the lower part just kind of fades into her complexion.

MS._Jen_RN, ASN, RN · Jul 24, 2007

Often the pictures that are shown in textbooks are the extreme cases. I have seen several pts c lupus, none with a well defined "butterfly" rash.

bigsyis · Jul 24, 2007

The lupus pts that I have seen appear almost like pts with Rosacea. I have never seen the well-defined mask, either.

nrsang97, BSN, RN · Jul 24, 2007

Because of the way I blush and turn so red so easily, I have been tested for SLE multiple times, I have also had s/sx other than the redness to go along with the redness. I was most recently tested due to finding out that I have avascular necrosis in my right knee. All thest for SLE have been negative. In many of the patients that I remember taking care of with Lupus none have had the "Butterfly" rash.

snowfreeze, BSN, RN · Jul 24, 2007

I have had 2 friends with Lupus, one had a poorly defined butterfly rash. She had dark hair and it appeared more as a ruddy complexion. She declined to needing port access for IV hydration to maintain renal function within about 6 or 7 years. She was also a critical care nurse so she was much more aware of all the problems with Lupus. She is still working as a pediatric home care nurse about 18 years after diagnosis.

The other one always had a nice rosy appearance to her cheeks but not a butterfly pattern. She was a childhood friend. In her early 20's she married, was diagnosed, got pregnant and died during the pregnancy. I had lost touch with her due to moving a lot while I was growing up ( I initially knew her when I was in 5th grade) I saw her obituary when I had moved back to that area and called her parents to offer my condolences, they filled me in.

Indy, LPN, LVN · Jul 25, 2007

I'm sorry to hear about your friend. Thanks to all for the responses.

bluiis923 · Jul 25, 2007

I too have a friend with it (17 years) and she looks like she may have applied her blush a little much... no "typical" butterfly pattern.