negative tests but butterfly rash

hi!  about 2-3 months my sister went to dermatologist because of itchy red rash on her cheeks/nose. she was using hormonal cream which was helping but she wanted to stop using it, thought it is addiction. doctor sent her to see rheumatologist as suspected lupus. all blood tests were negative. still the rash is there. she has to use the cream all the time. she also lost weight since i saw her last year (about 2-3 kilos probably). could it be lupus? i noticed on her arm she had a red spot about 1 cm big if that helps (discoid lupus?). normally she's had atopic dermatitis since early age but it didn't look like that. she says the spot on her arm is gone now as she used cream there.

so far she has no other symptoms, just says feels tired but as far as i can see she is living normally, so no extreme fatigue or anything.

could it be the beginning of lupus? i read that it takes a while for other symptoms to show. how long does it take???? how specific is the butterfly rash? could it be any other skin disease?

[karajo]

To answer your question, "how specific is the butterfly rash?"  Not very specific.  There are other things that can cause a butterfly rash.  They also look at symptoms and other lab results to dx lupus.

There are other things that cause a "butterfly rash".  They are discoid lupus, erysipelas, polymorphous light eruption, rosacea, seborrheic dermatiitis, and systemic lupus erythematosus.  I know w/ SLE there are major symptoms that go along w/ the face rash.  Actually you feel like the rash is the minor cause everything else is screaming so much louder.  

But this gives you some things to consider.  And there is always the allergic reaction to something.