What systemic condition is associated with a butterfly-shaped facial rash across the nose and cheeks?

A malar (butterfly) rash is a classic manifestation of systemic lupus erythematosus (SLE), appearing as an erythematous rash over the nose and both cheeks in a butterfly distribution. It is present in approximately 50% of SLE patients and is photosensitive (worsened by sun exposure). SLE is an autoimmune disease with multi-system involvement. Oral manifestations include mucosal ulcerations, sicca symptoms, and a lichenoid reaction pattern. Dental considerations: SLE patients may be on corticosteroids, hydroxychloroquine, or immunosuppressants, which affect dental management.