Butterfly rash is seen in

(A) Systemic lupus erythematosus # SLE:> Characteristic Malar (Butterfly) rash seen as fixed erythematous rash over the cheeks, & bridge of nose (photosensitive but scarring is absent) Patchy scalp hair loss is seen & Hair usually regrow in SLE (but not in DLE) Raynaud's phenomenon is present in 10%; Antibodies against double-stranded DNA (Anti ds DNA) & Anti Sm are most specific Where as Antinuclear antibody (Anti SS DNA) test is most sensitive; ANF (Antinuclear factor) is positive in 98% Treatment: Antimalarials (Chloroquine, Hydroxychloroquine) are used when skin & joint disease predominate; Steroids with Ccytotoxic immunosuppressants (Azathioprine, Cyclophosphamide, Methotrexate) may be required when NSAIDS & Antimalarials are insufficient to control symptoms 11 criteria for diagnosis of SLE are: Malar rash; Discoid rash; Photosensitivity; Oral ulcers; Arthritis; Serositis (pleuritis, pericarditis); Renal disorder; Neurological disorder (Seizures or Psychosis); Haematological disorder (Haemolytic anaemia, Leukopenia, Thrombocytopenia); Immunological disorder;Antinuclear antibody. SLE may cause Libman Sach's Verrucous type of endocarditis