Q: I have arthritis, plus a rash across my nose and cheeks. My doctor is treating me for acne, but I wonder if what I have is actually a rash related to lupus. Several members of my family, including my sister and daughter, have lupus. Is it possible that I also have lupus – even though the results of my laboratory tests are negative?

A: Arthritis is a feature of lupus. Rashes on the face are another that your doctor may take into account when making a diagnosis. Features of lupus also include a positive antinuclear antibody (ANA) test, abnormal blood- cell counts, pleurisy (inflammation of the lining of the lungs), pericarditis (inflammation of the membrane sac surrounding the heart), and evidence of kidney injury. 

Because you have family members with lupus, it is understandable that you are concerned about your own diagnosis. Indeed, the risk of lupus is increased among family members of those with the disease. On the other hand, it is entirely possible – even likely – that in the case of your facial rash, arthritis might have occurred with it by coincidence.

Unless you have other signs of the disease, including positive lab tests, I would assume that this is not a lupus rash. I would recommend that you trust your doctor, who has examined you and is familiar with your specific symptoms. If you are still uncertain and would like another opinion, I would suggest you consider seeing a rheumatologist.

Doyt Conn, MD, Rheumatologist