###Human: Why is there a red rash spreading over my cheeks and the bridge of my nose? ###Assistant: Hi. It looks like the rash one has from lupus (attachment removed to protect patient identity). But you are tested negative for it. Considering your other symptoms it is auto-immune in origin. Other causes could be drug-induced malar rash, polymyositis, rheumatoid arthritis, and scleroderma. In autoimmune diseases, there is a formation of antibodies against your own body substances and cells. It does not have any specific cause. The cause is multifactorial, genetic, environmental, etc. It affects almost all organs in the body. You have to do the following investigations to find the involvement of the particular systems. Complete blood count, ECG, and echo, urinalysis, X-ray chest, blood urea and creatinine, ESR, CRP, liver function test. If the abnormalities are present in any of the above tests, finally we have to do the antinuclear antibody titers, ENA profile, anti-ds DNA antibody, complement levels C3 and C4. NSAIDS, Hydroquinone, and Methotrexate, etc., are commonly used for the treatment of autoimmune diseases. Nowadays plenty of monoclonal antibody treatments are available. It cannot be cured. You can reduce the severity of the disease and avoid experiencing the symptoms.