The reason the malar rash of lupus spares the naso-labial fold is not known. This rash which spreads to the folds may not be due to lupus. Itchy localized rash can be due to allergic dermatitis, eczema, scabies, contact dermatitis (soap, powder, cosmetics), shingles, psoriasis, fungal infection like or Tinea.
Non itchy rash can be petechiae, which are pinpoint-sized red dots under the surface of the skin. They can result from autoimmune disorders, such as lupus or rheumatoid arthritis, bone marrow disorders such as leukemia, inflammation of the veins, as a side effect of certain medications like birth control pills. The red spots could be tiny bruises. Deficiency of Vitamin B12, folic acid, or Vit K could be the cause. They could also be fragile spider veins.
Since I cannot examine you and know other related conditions you may be having, nor is a detailed history possible on net, I have listed the various possibilities that should be looked into. Please consult your PCP to run tests and examination to clinch a diagnosis by referring to a skin specialist. Take care!
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