Seenie here from Moderator support, asking a question for a friend. (Yes, really!)
I have a friend who has been miserably ill for years, and who is finally going to see a rheumatologist. What she has looks a lot like Lupus, and the blood work that the rheumatologist has requested appears to be looking for Lupus.
She seems to have all the right symptoms, except she’s never had the rash. Does Lupus always come with the butterfly rash?