AboutCynthia Donlan Expertise I am comfortable answering questions about Systemic Lupus, diagnosis , lab results. Coping strategies.. I am not as comfortable answering questions about medications and interreactions.
Experience I am a woman who suffers with Systemic Lupus Erythematosus along with other autoimmune phenomenon. I am the Lower County Representwtive for the Lupus Foundation of PA, I am also the local support group facilitator.
Organizations Lupus Foundation OF PA
Publications I have been on several local talk shows discussing lupus. I have had a few articles published in Lupus Foundation of PA Newsletter. My story was published in the Platelet Foundation of America book on ITP a few years ago and I am always having articles in our local papers.
Education/Credentials I have a Bachelor of Science degree in Liberal Arts from College Misericordia and Masters of Science degree in Special Education from Bloomsburg University
Question About 10 years ago I developed a rash on my face and joint pain. I have been treated for rosacea for about a yr. with no improvement. Finally referred to a dermatologist. He ordered an ANA panel after looking at my face and asking about my other symptoms which are:joint pain, arthritis, hair loss, fatigue, heart palpitations and pain when taking a deep breath, difficulty swallowing and Raynauds. The ANA panel came back positive with a centomere pattern, but no obvious skin symptoms of Crest. Any ideas? I have an appt. with a rheumatologist on Oct. 7th and want to be as well prepared as possible...Thanks!
Answer Dear Laurie,
Hello! Sorry I have taken so long to get back to you. Your appointment has come and gone. I hope it went well. I was in a flare for ther past 4 weeks and did not even go on my computer much.
lets begin with the anti-centromere antibodies.
Anti-centromere antibodies (ACA) are a marker for the CREST syndrome variant of Scleroderma.
Anti centromere pattern of ANA can be seen by people with Raynauds syndrome alone. However Patients who develop CREST often present with Raynaud’s phenomenon years before other features of the syndrome are manifest. The presence of ACA may help to identify such patients early in the course of the disease, prior to development of other features of CREST.
ACA have been found also in the sera of some patients with primary biliary cirrhosis (PBC)
They are very rare in other rheumatic conditions and in healthy persons.
Now on to Rosacea and malar rashes.
The malar rash is a redness or rash that may appear in a butterfly configuration across the nose and cheeks. It can appear on one or both sides of the face and is usually flat. In rosacea, the rash does not have the butterfly configuration.
The lupus butterfly rash may be one of the first signs that you may have lupus. This rash is characterized by a butterfly-shaped red rash that extends over the bridge of the nose and the cheeks. The rash may be flat or raised. The malar rash often appears or gets worse after sun exposure (photosensitivity) or stress that causes an increase in the circulation to the skin.
Sometimes the lupus butterfly rash appears on other parts of the body as well, usually on the trunk, arms or legs. The malar rash normally is itch-free and painless, although it may itch and cause a burning sensation. Sometimes the malar rash accompanies a flare
The reason the malar rash is shaped like a butterfly is because it follows the angle that the UV rays land on the skin. The malar rash is caused by a malfunctioning immune system, which causes the body to attack healthy tissues in the skin.
Rosacea is a potentially progressive neurovascular disorder that generally affects the facial skin and eyes. The most common symptoms include facial redness and inflammation across the flushing zone – usually the nose, cheeks, chin and forehead ; visibly dilated blood vessels, facial swelling and burning sensations, and inflammatory papules and pustules.
The rosacea rash can be all over the face, while the lupus rash is normally seen in the butterfly pattern.
Rosacea is a skin disease typically appearing in people during their 30s and 40s. It is marked by redness (erythema) of the face, flushing of the skin, and the presence of hard pimples (papules) or pus-filled pimples (pustules), and small visible spider-like veins called telangiectasias. In later stages of the disease, the face may swell and the nose may take on a bulb-like appearance called rhinophyma.
Up to one half of patients with rosacea may experience symptoms related to their eyes. Ocular rosacea, as it is called, frequently precedes the other manifestations on the skin. Most of these eye symptoms do not threaten sight, however. Telangiectasia may appear around the borders of the eyelid, the eyelids may be chronically inflamed, and small lumps called chalazions may develop.
The many symptoms that mimic rosacea and the many skin conditions with symptoms similar to rosacea can make the diagnosis of rosacea difficult. Medications used in the treatment of acne can be too harsh or aggressive leading to the onset of rosacea or acne rosacea.
Dozens of factors can lead to rashes which, on the surface, may resemble lupus-like skin abnormalities. An allergic reaction to an environmental toxin, a brush with poison oak and even certain patterns of skin bruising due to shaving or waxing can resemble a traditional lupus face rash. Look for other possible causes like a recent encounter with a pet to which you might be allergic, a recent sunburn or other skin aggravation.
Only a physician using proper medical tests can assess the presence or absence of lupus to an exacting degree. Skin must be biopsoed to be conclusive.
I hope this letter helped. I do care it just that I am a bit slow in getting strted.
