TL;DR: The butterfly rash and malar flush are common facial manifestations of several disorders and may be caused by graft-versus-host disease in a patient undergoing bone marrow transplantation.
Abstract: The butterfly rash and malar flush are common facial manifestations of several disorders. Systemic lupus erythematosus may produce a transient rash before any other signs. In pellagra, symmetric keratotic areas on the face are always accompanied by lesions elsewhere on the body. Erysipelas produces brawny, fiery red facial lesions, and scarlet fever causes facial eruptions as part of a generalized eruption. Lupus vulgaris and lupus pernio produce nodules that may spread in a butterfly pattern, and seborrheic dermatitis has a predilection for the malar prominences and other areas of the face. Carcinoid syndrome often causes flushing attacks that vary in duration, and facial flushing that lasts throughout treatment may accompany chemotherapy if the patient has a hypersensitivity reaction. Deep-red rashes and/or lichenoid lesions may be caused by graft-versus-host disease in a patient undergoing bone marrow transplantation.
TL;DR: The distinctive malar flush or "butterfly" eruption which characterizes systemic lupus erythematosus (SLE) and other butterfly eruptions illustrated in this section are associated with unrelated dermatologic conditions of no great medical concern.
Abstract: Physicians are aware of the distinctive malar flush or "butterfly" eruption which characterizes systemic lupus erythematosus (SLE) (Fig 1). The other butterfly eruptions illustrated in this section are associated with unrelated dermatologic conditions of no great medical concern. Needless anxiety for either patient or physician may be avoided if the lesions are examined for the characteristic morphologic signs. Seborrheic dermatitis of the malar areas may appear as a symmetrical erythema involving the butterfly area. The lesion is granular to the touch and is covered by a greasy scale (Fig 2) unlike the erythema, edema, and telangiectasia of SLE. Erythema and scaling of the scalp, eyebrows, and retroauricular areas as well as marginal blepharitis are also usually found. Acne rosacea of the malar areas presents a more difficult diagnostic problem (Fig 3) since telangiectasia is a constant feature which with the erythema may easily be confused with SLE. Unlike SLE acneiform
TL;DR: The clinical picture was variable, sometimes closely resembling rosacea and sometimes peri‐oral dermatitis, taking an average of 1 year to clear.
Abstract: Summary.—
Eleven children have shown similar changes on the facial skin. A bright malar flush was accompanied at times by small superficial papules, pustules and scaling. The clinical picture was variable, sometimes closely resembling rosacea and sometimes peri-oral dermatitis, taking an average of 1 year to clear.
Seven of the 11 children had a family history of atopy, and 2 had a family history of rosacea. Potent topical corticosteroids may have played a role in the cause of these children's rash and, on withdrawal, there was sometimes a pustular exacerbation. The relationship to rosacea and peri-oral dermatitis is discussed.