malar rash after sun exposuremalar rash after sun exposure

Lupus - symptoms. A malar rash is a skin rash that appears on the cheeks and bridge of the nose. Yazdany J, Panopalis P, Gillis JZ, Schmajuk G, MacLean CH, Wofsy D, et al. Jia J, Xie J, Li H, Wei H, Li X, Hu J, et al. 2019 Jul 10. Acta Reumatol Port. 45(2):191-202. Photosensitivity refers to various symptoms, diseases and conditions caused or aggravated by exposure to sunlight. 2016 Aug 10. [Full Text]. Gino A Farina, MD, FACEP, FAAEM Associate Professor of Clinical Emergency Medicine, Albert Einstein College of Medicine; Program Director, Department of Emergency Medicine, Long Island Jewish Medical Center, Gino A Farina, MD, FACEP, FAAEM is a member of the following medical societies: American Academy of Emergency Medicine, American College of Emergency Physicians, and Society for Academic Emergency Medicine, Elliot Goldberg, MD Dean of the Western Pennsylvania Clinical Campus, Professor, Department of Medicine, Temple University School of Medicine, Elliot Goldberg, MD is a member of the following medical societies: Alpha Omega Alpha, American College of Physicians, and American College of Rheumatology, Julie Hildebrand, MD Consulting Staff, Department of Internal Medicine, Associated Physicians of Madison, WI, Richard S Krause, MD Senior Clinical Faculty/Clinical Assistant Professor, Department of Emergency Medicine, University of Buffalo State University of New York School of Medicine and Biomedical Sciences, Richard S Krause, MD is a member of the following medical societies: Alpha Omega Alpha, American Academy of Emergency Medicine, American College of Emergency Physicians, and Society for Academic Emergency Medicine, Viraj S Lakdawala, MD Clinical Instructor of Emergency Medicine, University of California, San Francisco, School of Medicine; Attending Physician, San Francisco General Hospital, Viraj S Lakdawala, MD is a member of the following medical societies: American Academy of Emergency Medicine and American College of Emergency Physicians, Mark J Leber, MD, MPH Assistant Professor of Emergency Medicine in Clinical Medicine, Weill Cornell Medical College; Attending Physician, Lincoln Medical and Mental Health Center, Mark J Leber, MD, MPH is a member of the following medical societies: American College of Emergency Physicians and American College of Physicians, Carlos J Lozada, MD Director of Rheumatology Fellowship Program, Professor, Department of Medicine, Division of Rheumatology and Immunology, University of Miami, Leonard M Miller School of Medicine, Carlos J Lozada, MD is a member of the following medical societies: American College of Physicians and American College of Rheumatology, Disclosure: Pfizer Honoraria Speaking and teaching; Amgen Honoraria Speaking and teaching, Francisco Talavera, PharmD, PhD Adjunct Assistant Professor, University of Nebraska Medical Center College of Pharmacy; Editor-in-Chief, Medscape Drug Reference, Anuritha Tirumani, MD Research Coordinator, Department of Emergency Medicine, Brooklyn Hospital Center. Symptoms of a lupus butterfly rash (malar rash) include details such as it covers the cheeks and nose and is shaped like a butterfly, can happen suddenly or after sun exposure, usually appears red and raised, may be scaly, usually does not affect the nasal folds, may occur on its own, and affects about half of all patients who have lupus. Faurschou M, Mellemkjaer L, Starklint H, et al. Hu W, Ren H. A meta-analysis of the association of IRF5 polymorphism with systemic lupus erythematosus. Philadelphia, Pa: Elsevier Saunders; 2017. Available at https://www.lupus.org/understanding-lupus-0?utm_expid=.7AO1HbsrR9KO2Z8jF1HYTw.1&utm_referrer=. Careful history taking may help differentiate between the potential causes of fatigue or fever. [QxMD MEDLINE Link]. Evolution of disease burden over five years in a multicenter inception systemic lupus erythematosus cohort. Effectively measuring adherence to medications for systemic lupus erythematosus in a clinical setting. 81 (3):370-378. 64(6):797-808. 2010 Jan. 69(1):61-4. [Full Text]. Genetic susceptibility to systemic lupus erythematosus in the genomic era. J Rheumatol. Dall'Era M, Wofsy D. Clinical Manifestations of Systemic Lupus Erythematosus. There are many types of PT, each focusing on a different condition or demographic. [QxMD MEDLINE Link]. 2019 Mar. Rosacea: Diagnosis, treatment, and steps to take. Rheumatology (Oxford). [QxMD MEDLINE Link]. Trager J, Ward MM. 2nd ed. More commonly, accelerated ischemic coronary artery disease (CAD) is associated with SLE and may present indolently as atypical anginal equivalents. High risk of ischemic heart disease in patients with lupus nephritis. 397 (10289):2070-2080. 2016 Jan 12. Rainer BM, et al. [QxMD MEDLINE Link]. Lancet. 67 (6):817-28. Special consideration should be given to infectious causes (bacterial, viral [eg, CMV]), because of immunosuppression. 1997 Mar 1. The most common lesion is a facial eruption that characterizes acute cutaneous lupus erythema (also known as "the butterfly rash") that presents as erythema in a malar distribution over the cheeks and nose (but sparing the nasolabial folds) that appears after sun exposure (picture 2A-B). It is most often a sign of the autoimmune disease lupus, but there are other causes, too. Salman-Monte TC, Torrente-Segarra V, Almirall M, Corzo P, Mojal S, Carbonell-Abell J. Hajj-ali RA. American Academy of Dermatology. Ulff-Mller CJ, Simonsen J, Kyvik KO, Jacobsen S, Frisch M. Family history of systemic lupus erythematosus and risk of autoimmune disease: Nationwide Cohort Study in Denmark 1977-2013. It can be a manifestation of active lupus, infection, malignancy, or a drug reaction. Treatment for malar rash depends on the severity of your rash and the suspected cause. Lin TC, Wu JY, Kuo ML, Ou LS, Yeh KW, Huang JL. Malar rash in classical homocystinuria. Our experts continually monitor the health and wellness space, and we update our articles when new information becomes available. Many conditions can cause a malar rash. 2018 Aug. 70 (8):1251-1255. Association of Higher Hydroxychloroquine Blood Levels With Reduced Thrombosis Risk in Systemic Lupus Erythematosus. The Rheumatologist. Centers for Disease Control and Prevention. Am J Manag Care. The rash can be flat or. Manifestations of systemic lupus erythematosus. [QxMD MEDLINE Link]. [Full Text]. Osteonecrosis in patients with systemic lupus erythematosus develops very early after starting high dose corticosteroid treatment. [QxMD MEDLINE Link]. [QxMD MEDLINE Link]. One plus, though: "The malar rash in lupus usually heals without scarring," Dr. Brent says. Telangiectasias, erosions, dyspigmentation, and . Morris DL, Sheng Y, Zhang Y, Wang YF, Zhu Z, Tombleson P, et al. [93] 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 in Physical Examination). You may also need a chest X-ray and echocardiogram to look for heart damage. 2016 Jun 9. The condition can also result in vision problems, skeletal abnormalities, and intellectual disability. Acute cutaneous lupus may also cause: Canker sores (painful sores in your mouth). [Full Text]. 2009 Jul. Nausea and dyspepsia are common symptoms in patients with active SLE and are sometimes difficult to correlate with objective evidence of gastrointestinal involvement. How to diagnose lupus enteritis early? Anti-ribosomal P protein IgG autoantibodies in patients with systemic lupus erythematosus: diagnostic performance and clinical profile. SLE mortality remains disproportionately high, despite improvements over the last decade. It shows IgG deposit in the nucleus and nonspecific deposit in the cytoplasm. Understanding Lupus. Nonrenal disease activity following mycophenolate mofetil or intravenous cyclophosphamide as induction treatment for lupus nephritis: findings in a multicenter, prospective, randomized, open-label, parallel-group clinical trial. Mycophenolate mofetil versus cyclophosphamide for induction treatment of lupus nephritis. When lupus affects the skin, it is called cutaneous lupus erythematosus (CLE). Note the perioral sparing. Discoid lupus erythematosus is a chronic scarring skin condition causing scaly plaques on the scalp, face, and ears. Some people with lupus have no visible symptoms at all. Fessler BJ. Results from a single center. But the condition is not contagious. [QxMD MEDLINE Link]. Steroid creams often make the condition worse. Ann Rheum Dis. [QxMD MEDLINE Link]. Aringer M, Costenbader K, Daikh D, et al. N Engl J Med. van Assen S, Agmon-Levin N, Elkayam O, Cervera R, Doran MF, Dougados M, et al. 2013 Mar. These lesions consist of accumulation of immune complexes, platelets, and mononuclear cells. Lima GL, Paupitz J, Aikawa NE, Takayama L, Bonfa E, Pereira RM. 1(4):e208-e219. The diagnosis in a patient with shortness of breath, hemoptysis, and pleuritic chest pain is commonly made with ventilation-perfusion scans or computed tomography (CT) angiography. Using coconut oil for rosacea could help ease skin redness. Science. 2004 Jan. 43(1):7-12. The rash may come and go, and it can last for days or weeks at a time. Ginzler EM, Dooley MA, Aranow C, Kim MY, Buyon J, Merrill JT, et al. Butterfly rash mimicking sunburn erythema. Protecting the face from sun helps reduce malar rash. Anti-CD19 CAR T cell therapy for refractory systemic lupus erythematosus. American College of Rheumatology. [QxMD MEDLINE Link]. 2001 Mar 31. Diagnosing and treating lupus. IVS = interventricular septum; LA = left atrium; LV = left ventricle. Weight loss may occur in patients with active SLE. The butterfly-shaped rash on the cheeks and nose can occur spontaneously or after sun exposure. [QxMD MEDLINE Link]. Medicine (Baltimore). Patients often present with quite mild signs when they have a facial lesion or rash due to embarrassment and the diagnosis may be tricky. Available at https://www.rheumatology.org/I-Am-A/Patient-Caregiver/Diseases-Conditions/Living-Well-with-Rheumatic-Disease/Pregnancy-Rheumatic-Disease. Levy RA, Vilela VS, Cataldo MJ, Ramos RC, Duarte JL, Tura BR, et al. We avoid using tertiary references. Arthritis Rheum. ACLE skin rashes don't scar, but after they go away, your skin may look lighter or darker than it was before. Oinuma K, Harada Y, Nawata Y, Takabayashi K, Abe I, Kamikawa K, et al. 2021 May. Some tests that help identify lupus or rule out other conditions include: These tests look for signs of anemia (low blood cell count), autoimmune antibodies, or damage to your kidney, liver, heart, or lungs. A malar rash is a facial rash that forms on the cheeks and the bridge of the nose and is sometimes called a butterfly rash because of its shape. Nodler J, Moolamalla SR, Ledger EM, Nuwayhid BS, Mulla ZD. [QxMD MEDLINE Link]. [Full Text]. Richardson J. Pregnancy and Rheumatic Disease. [QxMD MEDLINE Link]. The malar rash, also known as the butterfly rash, extends from the cheeks across the nasal bridge. [QxMD MEDLINE Link]. [QxMD MEDLINE Link]. Please confirm that you would like to log out of Medscape. [QxMD MEDLINE Link]. [QxMD MEDLINE Link]. Malar rashes can be an early sign of lupus, before a person starts to notice other symptoms, Dr. Brent says. It lasts from days to weeks and is occasionally painful or pruritic. Note: It remains to be determined whether further subcategories have a prognostic difference. 2012 Feb. 64(2):159-68. 10(5):373-9. Morand EF, Furie R, Tanaka Y, Bruce IN, et al. Can diet help improve depression symptoms? 2011 Oct. 70(10):1752-7. All rights reserved. Sun rashes can present after exposure to the sun. Alveolar hemorrhage in systemic lupus erythematosus: a cohort review. Reprod Toxicol. Ramos-Casals M, Cuadrado MJ, Alba P, Sanna G, Brito-Zern P, Bertolaccini L, et al. Lupus. 2011 Mar. Because lupus can affect so many different organs, a wide range of signs and symptoms can occur. [QxMD MEDLINE Link]. Systemic lupus erythematosus. 70 (7):236-239. The genetics of systemic lupus erythematosus and implications for targeted therapy. Available at http://www.medscape.com/viewarticle/883270. [QxMD MEDLINE Link]. Systemic manifestations of SLE may be absent (ie, limited discoid lupus). Medicine (Baltimore). You can't catch lupus from someone else, even if they have a rash and you touch it. Lupus and your skin: self-care dermatologists recommend. Among other symptoms, it causes a malar rash and skin eruptions on other areas of the body. Mackensen A, Mller F, Mougiakakos D, Bltz S, Wilhelm A, Aigner M, et al. [QxMD MEDLINE Link]. Derivation and validation of the Systemic Lupus International Collaborating Clinics classification criteria for systemic lupus erythematosus. [QxMD MEDLINE Link]. Occasionally, abdominal tenderness and pain may be linked to peritonitis, pancreatitis, mesenteric vasculitis, or nonlupus-related processes. [QxMD MEDLINE Link]. 2001 Apr. 2011 Oct. 70(10):1726-32. Furie RA, Morand EF, Bruce IN, Manzi S, et al. However, there are treatments available when a person develops rashes due to lupus. Bramham K, Hunt BJ, Bewley S, et al. It lasts from days to weeks and is occasionally painful or pruritic. [QxMD MEDLINE Link]. 5 (1):e000285. 1345-67. Its also very common in the population. Oakley AM, Badri T, Harris BW. Remnants of secondarily necrotic cells fuel inflammation in systemic lupus erythematosus. The butterfly rash is a facial rash that blooms across the cheeks and nose. In fact, as mentioned, PMLE is a type of photodermatosis. Arthritis Care Res (Hoboken). In some cases, a red, bumpy rash will also show up on the arms, legs or other parts of the body, but they won't necessarily have a butterfly shape. Large blisters. A malar rash can occur with many different diseases and conditions, from sunburn to lupus. Rosacea now estimated to affect at least 16 million Americans. This is caused by a tick bite, which then transmits bacteria into the body. A history of multiple cytopenias such as leukopenia, lymphopenia, anemia, or thrombocytopenia may suggest SLE, among other etiologies, such as medication-related cytopenias. The presence of visible, swollen blood vessels under your skin and pustules might help a doctor distinguish rosacea from other disorders. Its presentation and course are highly variable, ranging from indolent to fulminant. Bloom syndrome, which is also called Bloom-Torre-Machacek syndrome, is an inherited disorder that is characterized by short stature and elevated rates of most cancers. Face: erosions / crusting Herpes simplex Monomorphic clustered vesicles or crusted papules Often locally recurrent in the same site Terrier B, Amoura Z, Ravaud P, et al. Theyll likely want to conduct a physical exam and other diagnostic tests before arriving at a diagnosis and treatment plan. What Causes Carpal Tunnel Syndrome During Pregnancy, and Hows It Treated? [QxMD MEDLINE Link]. 8 (1):9962. But if the rash has a butterfly-like shape, you could have a malar rash, which is more serious. 41(6):605-18. If your home gets a lot of sunlight, consider installing UV-blocking shades for your windows. Gatenby P, Lucas R, Swaminathan A. Vitamin D deficiency and risk for rheumatic diseases: an update. It can, Hypersplenism is a condition in which the spleen is overactive and removes too many blood cells from your bloodstream. 2014;150(3):344. doi:10.1001/jamadermatol.2013.10393. [Full Text]. Frequency of lupus in people of African origin. Lin YC, Wang AG, Yen MY. Kidney Int. Last medically reviewed on October 26, 2017. Firestein GS, Budd RC, Gabriel SE, MacInnes IB, ODell JR, eds. Polymorphous light eruption is the most common form of sun allergy. Others can experience various skin problems like a rash. [QxMD MEDLINE Link]. Seizures related to SLE may be generalized or partial and may precipitate status epilepticus. [QxMD MEDLINE Link]. Jennekens FG, Kater L. The central nervous system in systemic lupus erythematosus. Curr Opin Rheumatol. [113], 90% of glomeruli involved without residual activity 2011 Sep. 38(9):1906-13. While the butterfly rash (also called a malar rash or lupus rash) is one of the most commonly known symptoms people associate with lupus, it does not need to be present to be diagnosed with lupus. Share cases and questions with Physicians on Medscape consult. Coronary artery disease risk factors in the Johns Hopkins Lupus Cohort: prevalence, recognition by patients, and preventive practices. Polymorphous light eruption is a rash caused by sun exposure in people who have developed sensitivity to sunlight. Without washing or exfoliating, patches of dark, scaly, Medical News Today has strict sourcing guidelines and draws only from peer-reviewed studies, academic research institutions, and medical journals and associations. These conditions can be systemic (affecting the whole body) or local (affecting only the skin on the face). [115], Included with anti-Sm, SSA, and SSB in the ENA profile; may indicate mixed connective-tissue disease with overlap SLE, scleroderma, and myositis, IgG/IgM variants measured with ELISA are among the antiphospholipid antibodies used to screen for antiphospholipid antibody syndrome and pertinent in SLE diagnosis, Multiple tests (eg, direct Russell viper venom test) to screen for inhibitors in the clotting cascade in antiphospholipid antibody syndrome, Coombs testpositive anemia to denote antibodies on RBCs, Drug-induced lupus ANA antibodies are often of this type (eg, with procainamide or hydralazine; p-ANCApositive in minocycline-induced drug-induced lupus). Learn more about chafing rash and how to treat and, Anemia rash is a term that refers to red pinpricks that appear on the skin and are caused by a low platelet count. Because sunlight is often a trigger for malar rash in general, the first line of treatment is to limit your sun exposure and use sunscreen rated at SPF 30 or more. No. Health.com uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. The reason for the rash's shape is unclear, but it might be related to the parts of the skin exposed to the sun. Acute cutaneous lupus causes a butterfly-shaped rash on the cheeks and nose that looks like a sunburn (called malar rash). Klein-Gitelman M, Reiff A, Silverman ED. But typically, if a malar rash is present with other symptoms (such as arthritis, mouth ulcers, and Raynauds syndrome) and specific lab findings, a doctor can make a diagnosis. Stroke and transient ischemic attack (TIA) may be related to antiphospholipid antibody syndrome or SLE vasculitis. Kumar RR, Jha S, Dhooria A, Dhir V. Butterfly rash: hallmark of lupus. Arthritis Rheum. The first is malar rash, which is characterized by an erythematous rash over the cheeks and nasal bridge. An update upon efficacy and adverse events. [QxMD MEDLINE Link]. Headache and mood disorders may be the most commonly reported neurologic manifestation of SLE, but cause and effect may be difficult to distinguish. Causes linked to bacterial infection are treated with oral or topical antibiotics. Correlation between disease activity of pediatric-onset systemic lupus erythematosus and level of vitamin D in Taiwan: A case-cohort study. Systemic lupus erythematosus (SLE) is a chronic autoimmune disease that can affect almost any organ system. A butterfly rash is commonly caused by lupus (or systemic lupus erythematosus), an autoimmune disease where the body produces autoantibodies, or antibodies made by the immune system that are directed at the body's own proteins. [Full Text]. Though they share this common symptom, the two conditions arent related. (2010, Winter), Why Parkinson's research is zooming in on the gut. Systolic murmurs are reported in up to 70% of cases. 73 (6):997-1004. But one form of SLE, called cutaneous lupus erythematosus (CLE) affects just your skin, without other lupus symptoms. [QxMD MEDLINE Link]. The American College of Rheumatology nomenclature and case definitions for neuropsychiatric lupus syndromes. 2015 Sep 18. Why are people with lupus photosensitive? The exact features of a malar rash might vary depending on the underlying cause. The dynamic epigenetic regulation of the inactive X chromosome in healthy human B cells is dysregulated in lupus patients. Gladman DD, Urowitz MB, Chaudhry-Ahluwalia V, Hallet DC, Cook RJ. Ann Rheum Dis. The rash usually appears as tiny, inflamed bumps or slightly raised patches of skin. Lupus. Vitamin D insufficiency and deficiency in mexican patients with systemic lupus erythematosus: Prevalence and relationship with disease activity. 1985 Feb. 12(2 Pt 1):278-88. Currently, theres no cure for lupus. Clin Exp Rheumatol. Broder A, Khattri S, Patel R, Putterman C. Undertreatment of Disease Activity in Systemic Lupus Erythematosus Patients with Endstage Renal Failure Is Associated with Increased All-cause Mortality. Lanata CM, Chung SA, Criswell LA. 2023 Lupus Foundation of America. Malar rashes are slightly bumpy with a raised border, and in some cases they can spread upward toward the forehead or down toward the chin, says Lawrence Brent, MD, associate director of the Rheumatology Fellowship Program at Temple University Hospital in Philadelphia. These rashes often appear after sun exposure, although they are not a sunburn. Weight gain may also be due to corticosteroid treatment or active disease, such as nephrotic syndrome (with anasarca) or myocarditis. 2016 Aug. 48 (8):940-946. Ann Rheum Dis. [107]. June 9, 2022; Accessed: June 15, 2022. Boumpas DT, Austin HA 3rd, Vaughn EM, Klippel JH, Steinberg AD, Yarboro CH, et al. The classic malar rash, also known as a butterfly rash, with distribution over the cheeks and nasal bridge. 8th ed. Although the interphalangeal spaces are affected, the metacarpophalangeal (MCP) and proximal interphalangeal (PIP) and distal interphalangeal (DIP) joints are spared. Consider contacting a doctor if a butterfly-shaped rash appears on your face. [Full Text]. You can learn more about how we ensure our content is accurate and current by reading our. European League Against Rheumatism recommendations for monitoring patients with systemic lupus erythematosus in clinical practice and in observational studies. 2015. 2005 Sep. 44(9):1101-7. Supporting lupus patients and advocates in Arizona. Medicine (Baltimore). 2010 Dec. 69(12):2083-9. Timing and Predictors of Incident Cardiovascular Disease in Systemic Lupus Erythematosus: Risk Occurs Early and Highlights Racial Disparities. [QxMD MEDLINE Link]. 2016 Jul. Age-specific incidence rates of myocardial infarction and angina in women with systemic lupus erythematosus: comparison with the Framingham Study. Epidemiology of systemic lupus erythematosus: a comparison of worldwide disease burden. Aseptic meningitis, myelopathy, optic neuropathy, or other demyelinating disorders may also require urgent evaluation. Zucchi D, Elefante E, Schilir D, Signorini V, Trentin F, Bortoluzzi A, et al. Note: Class V may occur with class III or IV (then, both cases would be diagnosed) J Am Soc Nephrol. Be sure to tell a doctor if you have any other symptoms, like a fever or joint pain, along with your rash. Investigating the power of music for dementia. [QxMD MEDLINE Link]. Murdaca G, Colombo BM, Puppo F. Emerging biological drugs: a new therapeutic approach for Systemic Lupus Erythematosus. 365(22):2110-21. 13(10):777-83. Systemic lupus erythematosus (SLE). [Full Text]. Nat Med. Urowitz MB, Bookman AA, Koehler BE, Gordon DA, Smythe HA, Ogryzlo MA. Rheumatology. Photosensitive rash is often macular or diffusely erythematous in sun-exposed areas of the face, arms, or hands and generally persists for more than 1-2 days (see the image below). Morbidity and mortality in systemic lupus erythematosus during a 5-year period. 2016 Jan. 68 (1):91-8. If you have a rash on your face, a dermatologist will first examine your skin. 2000 May. 2010 Oct. 37(10):2032-8. To avoid triggering the rash in the first place, try to avoid direct exposure to the sun. Lupus and your skin: signs and symptoms. There is no cure for dermatomyositis, but medications and physical therapy can help.. A malar rash is a symptom of an underlying condition, so your doctor will need to diagnose what's causing it. academic.oup.com/bjd/article/179/2/282/6730927, aad.org/public/diseases/rosacea/triggers/prevent, lupus.org/resources/is-a-butterfly-rash-definite-indicator-of-lupus, lupus.org/resources/lupus-facts-and-statistics, cdc.gov/chronicdisease/resources/publications/factsheets/lupus.htm, aafp.org/pubs/afp/issues/2015/0801/p187.html, ncbi.nlm.nih.gov/pmc/articles/PMC5821167/, niams.nih.gov/health-topics/rosacea/diagnosis-treatment-and-steps-to-take, aad.org/public/diseases/rosacea/what-is/causes, 8 Medical Treatments and Home Remedies for Ocular Rosacea, Debra Sullivan, Ph.D., MSN, R.N., CNE, COI, 7 FAQs About Caring for Rosacea-Prone Skin, Papulopustular Rosacea: Symptoms, Triggers, and Treatment, redness, flushing, or blushing on the face, often with visible blood vessels, systemic (SLE) or localized to your skin (CLE), may include disc-shaped sores or scaly lesions or small red or purple spots or bumps, small, red, pus-filled bumps on the face that look like acne, flat, slightly raised, or pus-filled bumps, Wear long sleeves, pants, and wide-brimmed hats when you go outside during the day.

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