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Taking imuran for crohn's disease. Red rashes on cheek not getting cured. Worried for lupus

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Practicing since : 2010
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Hi. I am a 35 year old female. I have a history of Crohn's Disease, but it is currently in remission. For the Crohn's I am on Imuran and allopurinol, and I used to be on Humira. I recently developed (4 days ago) a reddish pink flat rash on my cheeks and nose that feels warm to the touch and doesn't itch. It looks like a sunburn, but I haven't been in the sun or wind. I haven't used any new medications, cosmetics, lotions, detergents, foods, etc. I have tried antihistamines, sensitive skin products, etc. Nothing is helping. I have never had a problem with sensitive skin before this. I have included a picture of the rash. I am worried it could be something like lupus since I already have Crohn's.
Posted Sun, 17 Mar 2013 in Lupus
Answered by Dr. Rahul Kumar 45 minutes later
Thanks for writing to us.
Chron's disease is known for cutaneous lesions.
Usually there are raised skin lesions (nodules) seen around the anal area. Such nodules can even be seen on other parts of body and there can be ulcerations.
Regarding your condition,
you have sent an excellent photograph, which clearly shows there is involvement of malar area and bridge of nose. If you notice the nasal folds are spared.
This is typical of photosensitivity. The reason for this can be..
1. Lupus, already mentioned by you.
2. Photo reaction due to medication taken by you.(mainly allopurinol)
For photo reaction to develop, even artificial light is enough. You need not go in sunlight.
Here is my advice for you.
1. Use sunscreen with 50+ spf, daily thrice, even if you are indoors.
2. Use a mild topical steroid once in night for a week.
3. Get an XXXXXXX profile of blood done to rule out Lupus.
I would have not considered lupus, but since it is associated with chron's the above test becomes important.
Once lupus is ruled out, drug related photosdositivity can be thought of.
Let me know if you have any further query.
Wishing you good health.
Thank you
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