What is a butterfly rash (cheek rash)?

What is butterfly rash (cheekbone rash), causes, mechanisms, meanings, images

Butterfly rash, cheek rash, Systemic lupus erythematosus nephropathy update
Butterfly wings


A red yellow or purple spot, gently scaly rash, seen on the bridge of the nose and on both cheeks in the shape of a butterfly. The rash leaves out the nasolabial folds, helping to distinguish it from other rashes (eg, rosacea). It is also the examiner’s perception.


The exact mechanism is unclear. However, like the underlying disease in lupus erythematosus, it is thought to result from an autoimmune reaction due to genetic, environmental, and immunological factors.

Some of the elements shown to be involved include:

• An ineffective genetic predisposition or deficiency leads to a clear failure of the immune complex of self-destructive cells, thereby increasing the chances of autoimmune development.

• Sunlight has been shown to damage and/or induce apoptosis of keratinocyte proteins in the epidermis and may stimulate autoantibody production. Sunlight may increase the likelihood of keratinocytes being destroyed by complement and antibody-dependent mechanisms.

• Specific cellular and humoral immune responses have been seen in studies looking at skin manifestations of lupus.

It is possible that sun exposure is a combination of factors that lead to cutaneous immune deposition, lesions, edema, and characteristic cheek rashes.


Cheek rash is valuable in the diagnosis of lupus in the context of other signs or symptoms. It is seen in about 40% of SLE patients. Therefore, its absence does not exclude a diagnosis of the disease.


• Systemic lupus erythematosus

• Dermatomyositis

Mechanism of cheekbones
Mechanism of cheekbones

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