Hello @ejlm, Welcome to Connect. I know you must be terribly frustrated trying to figure out what's causing your symptoms. From what I have read, one of the symptoms of Lupus is the butterfly rash across the face.

Mayo Clinic - Lupus Symptoms & Causes: https://www.mayoclinic.org/diseases-conditions/lupus/symptoms-causes/syc-20365789

PubMed also has some information that you may find helpful here: The Butterfly Rash and the Malar Flush. What Diseases Do These Signs Reflect?
-- https://pubmed.ncbi.nlm.nih.gov/1824645-the-butterfly-rash-and-the-malar-flush-what-diseases-do-these-signs-reflect/

I'm tagging our moderator @ethanmcconkey to see if we should move your post to the following discussion where it will receive more visibility.

> Groups > Autoimmune Diseases > Tumid Lupus with SLE Symptoms?
-- https://connect.mayoclinic.org/discussion/tumid-lupus-with-sle-symptoms/

@ejlm have you thought about getting a second opinion at a major teaching hospital or Mayo Clinic? If you would like get a second opinion from Mayo Clinic, you can find the contact information for the Minnesota, Arizona and Florida campuses here http://mayocl.in/1mtmR63.