A malar rash may be flat or slightly raised, and it can feel rough and scaly. It may be itchy and, in severe cases, it may be painful. Many health conditions can cause a malar or butterfly rash, including: lupus.

Does lupus butterfly rash itch?

The rash associated with acute cutaneous lupus appears in a recognizable butterfly pattern that spreads across the nose and cheeks. This rash is flat, red, and itchy, and it usually appears after sun exposure. Occasionally, a rash may appear on other parts of the body, such as the arms and legs.

How long does a lupus malar rash last?

Malar rash is characterized by erythema over the cheeks and nasal bridge (but sparing the nasolabial folds, which is in contrast to the rash of dermatomyositis) (see the image below). It lasts from days to weeks and is occasionally painful or pruritic.