Theoretically, if one had the majority of the symptoms for Lupus, and even tested positive for SLE via a ANA blood test result, but still hasn't had a "Butterfly" rash ever to appear -- could they still be medically diagnosed with Lupus?

My Rhematologist was telling me that he does not diagnose anyone with Lupus unless they eventually develop a "Butterfly rash" -- otherwise he just diagnoses people that have all the Lupus symptoms (except the Butterfly), even if they tested positive for Lupus in the blood-work, as "fibromyalgia." To him, the Butterfly rash is the single most important hinge that swings a fibromyalgia diagnosis to a lupus diagnosis.

But everywhere I look online, not everyone that is positive for Lupus will experience the "Butterfly" Rash. Right? Or am I wrong? Is there medical information that explains either way, and how paramount this "Butterfly" Rash is?


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    SLE diagnosis or classification is based on a set of criteria of which a Lupus rash is just one. Most Lupus patients don't have a butterfly rash. Jan 20 '17 at 2:04
  • @GrahamChiu, yeah, that's what I keep reading over and over... So I don't know how to respond to my Rheumatologist when he states this. If you have any suggestions, let me know. I don't know why he's so fixated on that symptom. Jan 20 '17 at 2:32
  • Based on what you said, all his lupus patients have fibromyalgia until they develop the rash. That's of course nonsense. Jan 20 '17 at 2:56
  • @GrahamChiu, I guess I should get a second opinion? The waits are just so long to get a consult with a rheumatologist... but I suppose it's worth it in the end to find one with a more practical/realistic outlook. Jan 20 '17 at 3:43
  • Sounds like a good idea to get a second opinion when the first contradicts the published guidelines. Jan 20 '17 at 3:47

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