You’re the doctor: a case of sunburn, rosacea or systemic lupus erythematosus?

Is it sunburn, rosacea or systemic lupus erythematosus? One hot summer’s afternoon, 33-year-old single mum Janine comes to see you with her children. While normally energetic, today Janine isn’t her usual self and she winces in pain, reaching for something in her bag for one of the children. Janine is concerned about a rash she has developed across the bridge of her nose and cheeks. She was sitting in the sun about two days ago and feels that it is probably just sunburn, though she didn’t seem to burn anywhere else, despite wearing a T-shirt and shorts. Janine also mentions that