Skin Challenge: Butterfly Rash

Acute cutaneous lupus lesions occur when systemic lupus is active. The most typical form of acute cutaneous lupus is a malar rash–flattened areas of red skin on the face that resemble a sunburn.

When the rash appears on both cheeks and across the bridge of the nose in the shape of a butterfly, it is known as the "butterfly rash." This rash is characterized by an erythematous flat or raised rash across the bridge of the nose and cheeks, which usually spares nasolabial folds.  It can also appear on arms, legs, and body. These lesions tend to be very photosensitive and typically do not produce scarring, although changes in skin color may occur.

Women are more commonly affected than men in every age and ethnic group.

SPA MANAGEMENT:

What is the cause of the malar rash in your client?

SLE is an autoimmune disease that involves multiple organs in which the immune system produces numerous auto-antibodies that attack different tissues such as kidneys, joints, skin, brain, and heart.

Determine any medications; contraindications and cautions before proceeding with any spa treatment.

Treatments that can be offered:

  • Skin in client with SLE is sensitive to light so SPF is necessary at all times
  • De-stressing and relaxing services can be offered. Service choice is different for everyone – some people may prefer a gentle massage, others may prefer a pedicure, facial, or reflexology, etc.
  • In the areas of skin defects aka malar rash, the skin's defence may be compromised, allowing for microbial invasion of the epidermis resulting in anything from mild to serious infections of the skin. For an inflammatory skin condition, aromatherapy essential oils in an emollient base can include chamomile, lavender, sandalwood, essential oils, etc.  Ensure none of these essential oils conflict with any medication.
  • Camouflage makeup (green) can be used to balance out the red color from rashes, and lupus-related scars that have darker pigmentation may require a heavier based camouflage makeup.
  • Avoid laser and aggressive treatments as they can increase the risk of the Koebner phenomenon, which is when lupus develops in a skin area that's provoked or damaged.
  • Immunosuppressive medications are typically prescribed as well as corticosteroid medications and topical anti-inflammatory immunosuppressant creams.  Be aware of side effects on the skin from medications as this may require a modification to whatever service the client is seeking.

DISCLAIMER: Work within the scope of your license/certification.
 

Portrait of Mórag Currin. About the Author

Mórag Currin is a highly sought-after esthetic educator with more than 27 years of spa industry experience and more than twelve years of training and training management experience. She travels around the globe with her training and expertise, helping to raise the bar in the spa industry and to open the door to all people, regardless of skin type or health condition. To learn more about this topic and many other skin challenges, diseases, and symptoms, check out Mórag’s book, Health Challenged Skin: The Estheticians’ Desk Reference.

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