Why does the lupus malar rash spare the nasolabial folds?

Malar rash (also known as the “butterfly rash,”) is an acute manifestation of lupus (SLE) seen in over 50% of patients. It is a bilateral, erythematous maculopapular rash which spares the nasolabial folds. The rash will last anywhere from days to weeks, and it can be painful/ itchy. It is a photosensitivity phenomenon.

Suspected Mechanism: the nasolabial folds are a relatively UV protected surface and therefore less affected.

REFERENCES:

  1. Amre Nouh, Jodi Speiser, José Biller. Chapter 3 – Acquired neurocutaneous disorders. Handbook of Clinical Neurology. Volume 132, 2015, Pages 29-73
  2. Fitzpatrick’s Color Atlas and Synopsis of Clinical Dermatology, 8e. Klaus Wolff, Richard Allen Johnson, Arturo P. Saavedra, Ellen K. Roh. THE SKIN IN IMMUNE, AUTOIMMUNE, AUTOINFLAMMATORY, AND RHEUMATIC DISORDERS.

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