Well, the derm says it's not skin lupus. He said my face rash is rosacea. I asked him how this rash could be connected to all my physical symptoms. He said that isn't his job to figure out, that is the rheumy's job. He said that he has a thousand patients with rosacea and none of them have the physical complaints that I have. He said I can still have SLE, but I definitely don't have skin lupus.
Here's the thing though, I don't think my malar rash is rosacea. The pathology report said "Psoriasisiform dermatitis, probably seborrheic dermatitis"......probably? lol!!!! They can't give me a concrete answer even with a biopsy? We know it's definitely NOT seborrheic dermatitis for one, because it doesn't behave like that kind of rash and for two, it didn't respond to treatment for it when we tried that.
So my doctor is saying rosacea, I feel, because he has no other way to explain the rash on my face. But no one can answer to me why I get this horrible rash, and then over the course of the next several months I'm in complete agony physically, having fevers, my hair falling out, sores in my nose and mouth, joints swelling and aching......the list goes on and on.
In the meantime my rheumy wants me to get a complete infectious disease workup before I see him again. Fine. No problem. So when all that comes back normal, then what? These people are making me feel like I'm a crazy person, like I'm making this stuff up or something. Why won't something, some kind of concrete clue show up in my blood work so I can get some treatment? Ugh I'm so frustrated. Sorry for ranting. :(
Let me see if I can help you sort it out. Psoriasisiform dermatitis is a description not a diagnoses. They are describing what the sample looks like not what it is. Seborrheic Dermatitis is often though to be flaky skin or dandruff. Its not It most frequently occurs with rosacea. Its Painful, red, often extends into the ears and even eyes hair falls out, sores in yournose and mouth. It is particularly prevalent in the oil glands. It HURTs and becaus ethe condition occurs in the fols of skin joints get involved.
In dermatology , it's what you see and where you see it. Biopsy won't distinguish between the two Neither Seborrheic Dermatitis or Rosacea is curable. and both are very resistant to treatment. The main difference is if The rash gets better with steroids, its likely Seborrheic Dermatitis, if it gets worse, its likely Rosacea. But as I said both occur together about 30% of the time. The good news is that the biopsy can eliminate several very worrisome cause of the rash including lupus, staph and even HIV.
The infectous disease work up make a lot of sense as there are several forms of reactive arthritis that can show up with those symptoms. They are generally fairly treatable Psoriasisiform dermatitis can also be a precursor of several other types of arthritis. Hang in there.
Hi. This totally sounds like my story. I have been having major symptoms as well and the rash appeared at the same time the other symptoms started. It’s not that I want Lupas but I definately know something is wrong and I’m just looking for answers. I totally can relate and I hope u find your answers soon.