A 54 female friend (here in the UK) with longstanding RA, well controlled for past few months with the TNF Adalimumab, recently had a bad chest infection, treated with antibiotics, and then, a week later, developed a butterfly rash and rash on hands and up arms, apparently photosensitve. Her GP changed the antibiotics but was not too concerned as the rash is fading. However I understand this can be a symptom of cutaneous SLE - a rare reaction to TNF that can show some months after treatment begins. She wants to know whether to give herself the next TNF injection now as its a week overdue. She has not been able to speak to her rheuamtologist but the nurse at the clinic seemed to think this could just be an allergic reaction to antibiotics.  Is this possible?  I myself can find no reference to antibiotics causing a classic butterfly rash (with white nose). I am concerned she gets more info asap. The RA helplines are all now closed for the weekend in the UK. Her chest is still not clear. Only other symptom is tiredness.