Yes, it is possible to have Lupus with a negative ANA. Yes, it is possible to have Lupus without a malar rash.
Lupus is diagnosed by having 4 of 11
of the lupus symptoms. Many doctors rely primary on blood work, but that isn't the best diagnostic fit, as a +ANA can mean any of several autoimmune diseases. A good rheumatologist takes ALL the symptoms into consideration when making a diagnosis.
Hope that helps,
Lynnwood, Lupus & Sjogren's Moderator
"Life is far too important to be taken seriously" - Oscar Wilde