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Difference Between Rosacea and Malar Rash

Rosacea is an inflammatory skin condition that manifests as a prominent red appearance on the face and eyes. Malar rash, also known as butterfly rash, is a red eruption on the cheeks and the nasal bridge.

What is rosacea?

Definition:

Rosacea is an inflammatory skin condition that manifests as a prominent red appearance on the face and eyes.

Symptoms:

Common signs and symptoms of rosacea include frequent flushing which is bouts of facial redness, persistent redness, red bumps and pimples of skin, telangiectasia, irritation in the eyes, a stinging or burning sensation on the face, and facial edema.

Location:

Rosacea affects the nose, chin, cheeks, eyes, forehead, ears, scalp, neck, and chest.

Causes:

The exact cause of rosacea is unknown. However, the disease is considered inflammatory in nature. The abundance of skin mites or the presence of an ongoing infection is known to cause rosacea. Also, the malfunction of protective skin proteins is linked with the disease.

Diagnosis:

Rosacea is diagnosed by a dermatologist through medical history and physical examination.

Treatment:

Oral medications like antibiotics and topical gels like Brimonidine and azelaic acid are used to subside pimples and redness in rosacea. Laser treatment can control telangiectasia and surgery might be needed if nose disfigurement occurs.

What is Malar rash?

Definition:

Malar rash, also known as butterfly rash, is a red eruption on the cheeks and the nasal bridge.

Symptoms:

Malar rash is a red, or purplish rash that occurs on the cheeks and nasal bridge. It can be itchy or rough and scaly in texture. 

Location:

A malar rash occurs on the cheeks and nasal bridge.

Causes:

Causes of malar rash include autoimmune disorders like systemic lupus erythematosus, seborrheic dermatitis, bacterial infections, such as Lyme disease, and rosacea, nutritional deficiencies like pellagra, genetic disorders, and ultraviolet sensitivity.

Diagnosis:

After history and examination, a doctor will order additional tests if he suspects a malar rash. These include specific antibody tests for lupus such as antinuclear antibody tests and ESR/CRP. Niacin levels might be ordered if pellagra is suspected.

Treatment:

Malar rash is treated according to its cause. If lupus is present, nonsteroidal anti-inflammatory drugs (NSAIDs), antimalarials, steroids, and immunosuppressants would be prescribed. If there is a bacterial infection, antibiotics are given. Sensitive skin is protected via topical sunscreens and lotions.

Difference between Rosacea and Malar rash

Definition:

Rosacea is an inflammatory skin condition that manifests as a prominent red appearance on the face and eyes. Malar rash, also known as butterfly rash, is a red eruption on the cheeks and the nasal bridge.

Symptoms:

Common signs and symptoms of rosacea include frequent flushing which is bouts of facial redness, persistent redness, red bumps and pimples of skin, telangiectasia, irritation in the eyes, a stinging or burning sensation on the face, and facial edema. Malar rash is a red, or purplish rash that occurs on the cheeks and nasal bridge. It can be itchy or rough and scaly in texture. 

Location:

Rosacea affects the nose, chin, cheeks, eyes, forehead, ears, scalp, neck, and chest. A malar rash occurs on the cheeks and nasal bridge.

Causes:

The exact cause of rosacea is unknown. However, the disease is considered inflammatory in nature. The abundance of skin mites or the presence of an ongoing infection is known to cause rosacea. Also, the malfunction of protective skin proteins is linked with the disease. Causes of malar rash include autoimmune disorders like systemic lupus erythematosus, seborrheic dermatitis, bacterial infections, such as Lyme disease, and rosacea, nutritional deficiencies like pellagra, genetic disorders, and ultraviolet sensitivity.

Diagnosis:

Rosacea is diagnosed by a dermatologist through medical history and physical examination. 

After history and examination, a doctor will order additional tests if he suspects a malar rash. These include specific antibody tests for lupus such as antinuclear antibody tests and ESR/CRP. Niacin levels might be ordered if pellagra is suspected.

Treatment:

Oral medications like antibiotics and topical gels like Brimonidine and azelaic acid are used to subside pimples and redness in rosacea. Laser treatment can control telangiectasia and surgery might be needed if nose disfigurement occurs. Malar rash is treated according to its cause. If lupus is present, nonsteroidal anti-inflammatory drugs (NSAIDs), antimalarials, steroids, and immunosuppressants would be prescribed. If there is a bacterial infection, antibiotics are given. Sensitive skin is protected via topical sunscreens and lotions. 

Table of differences between rosacea and malar rash

FAQs

Can you have rosacea and malar rash?

Yes, rosacea can cause a malar rash.

How can you tell the difference between malar rash and rosacea?

Rosacea affects the nose, chin, cheeks, eyes, forehead, ears, scalp, neck, and chest whereas malar rash occurs only on the cheeks and nasal bridge.

What does a malar rash feel like?

Malar rash is a red, or purplish rash that occurs on the cheeks and nasal bridge. It can be itchy or rough and scaly in texture. 

What aggravates malar rash?

Ultraviolet light exposure can aggravate the malar rash.

How do I know if I have a lupus rash or rosacea?

Lupus rash will present with other manifestations of lupus. Antibody tests will help rule out lupus. Rosacea will present with red bumps or pimples on the skin.

Can rosacea be mistaken for lupus rash?

Yes.

How do I know if my face rash is lupus?

Lupus rash will be butterfly-shaped, involving the cheeks and nasal bridge. Furthermore, antibody tests are used to identify lupus.

What autoimmune is linked to rosacea?

Rosacea is linked with type 1 diabetes, celiac disease, multiple sclerosis, and rheumatoid arthritis.

Can you have a malar rash without lupus?

Yes. A malar rash can occur in seborrheic dermatitis, bacterial infections, such as Lyme disease, rosacea, nutritional deficiencies like pellagra, genetic disorders, and ultraviolet sensitivity.

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References :


[0]Powell, Frank C. "Rosacea." New England Journal of Medicine 352.8 (2005): 793-803.

[1]Rad, Sara Naji, and Priyanka Vashisht. "Malar Rash." StatPearls [Internet]. StatPearls Publishing, 2021.

[2]Wilkin, Jonathan K. "Rosacea: pathophysiology and treatment." Archives of dermatology 130.3 (1994): 359-362.

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