Temporary Disabled. :) please Go back DermNet® - Facial rashes www.fgks.org » Address: [go: up one dir, main page] Include Form Remove Scripts Accept Cookies Show Images Show Referer Rotate13 Base64 Strip Meta Strip Title Session Cookies Search DermNet CtrlK Are you a healthcare professional GO TO DERMNET PRO Home Topics A-Z Images Cases Skin checker Translate Jobs Give feedback Main menu Home Topics A-Z Images Cases Skin checker Translate Jobs Give feedback Common skin conditions Acne Athlete's foot Cellulitis Cold sores Dermatitis/Eczema Heat rash Hives Impetigo Psoriasis Ringworm Rosacea Seborrhoeic dermatitis Shingles Vitiligo NEWS Check out what's new with DermNet Read more Quick links Skin checker Try our skin symptom checker Home Topics A-Z Facial rashes Facial rashes — extra information Categories: Rashes ADVERTISEMENT Rashes Facial rashes Author: Hon A/Prof Amanda Oakley, Dermatologist, Hamilton, New Zealand, May 2016. Erosions and crusting Dry or scaly rash Papulopustular rash Erythema Brown macules and patches Pale or white macules and papules Skin lesions Facial rashes Patients often present with quite mild signs when they have a facial lesion or rash — due to embarrassment — and the diagnosis may be tricky. Significant itch suggests atopic dermatitis or contact dermatitis. Face: erosions/crusting Herpes simplex Monomorphic clustered vesicles or crusted papules Often locally recurrent in the same site Swabs: Herpes simplex Herpes zoster Acute dermatomal eruption Painful: pain may precede the rash Erythema may precede vesicles Swabs: Herpes zoster Impetigo Irregular enlarging plaque Honey-coloured crusts Swabs for impetigo: Staphylococcus aureus +/- Streptococcus pyogenes Herpes simplex Herpes zoster Impetigo Dry or scaly rash Seborrhoeic dermatitis Seborrhoeic dermatitis often also affects scalp, retroauricular sites, ears Hairline, eyebrows, medial cheeks, nasolabial folds, chin creases Scaly blepharitis Poorly defined, variable white or yellowish flaking May have erythematous patches or thin plaques Follicular prominence or follicular digitate keratoses Psoriasis Psoriasis sites include eyelids, temples, retro- and pre-auricular skin and/or seborrhoeic dermatitis sites Also affects scalp, ears, elbows, knees, nails Well-demarcated erythematous plaques White scale More persistent than seborrhoeic dermatitis Atopic eczema Atopic dermatitis often affects flexures: retroauricular, elbow and knee creases Symmetrical dermatitis of eyelids, perioral skin (up to lips) Intensely itchy Acute flare: oedema, erythema, crusting, fissuring Subacute: dryness, pinkness Chronic: dryness, lichenification, Dennie Morgan folds (2 creases in lower eyelids) Atopic eczema Psoriasis Seborrhoeic dermatitis Contact eczema Acute, relapsing/intermittent or chronic presentation Irregular, variable, unilateral or asymmetrical dermatitis Sharp border if contact irritant dermatitis Patch tests positive if contact allergic dermatitis Photosensitive dermatitis Exposed areas of face, arms, chest, legs Spares under hair, eyelids, creases Flares after exposure outdoors Can be drug-induced Contact eczema allergic Contact eczema irritant Photosensitive dermatitis Tinea faciei Asymmetrical eruption Annular configuration is common Scaly edge Mycology positive Actinic keratoses Located on sun-exposed sites of temples, forehead, nose, cheekbones, angle of jaw, upper lip, lower vermilion lip Actinic keratoses often involves persistent tender scaly papules, macules, plaques Actinic keratoses Tinea faciei Tinea faciei Cutaneous lupus erythematosus Discoid lupus erythematosus Nose, cheeks, ears, lips, scalp Circumscribed plaques with follicular prominence, scale Post-inflammatory pigmentation, atrophic scarring CBC, ANA, ENA often normal Lupus tumidus / Jessner lymphocytic infiltrate Cheeks, upper trunk Smooth surface to erythematous dermal plaques Discoid lupus erythematosus Lupus tumidus / Jessner lymphocytic infiltrate Papulopustular rash Acne Acne Closed comedones Onset of acne often at puberty Usually, symmetrical forehead, chin, lateral face, nose Mixed inflammatory and non-inflammatory lesions Papules, pustules, nodules, comedones Perioral/periorificial dermatitis Usually adult females using face cream, often topical corticosteroid Often, asymmetrical first in perioral sites, later in perinasal and periocular sites Spares a centimetre of skin around vermilion of lips Grouped erythematous papules and pustules on erythematous patches, flaky surface Can occur in children Rosacea Most prevalent in middle-aged adults Mid-facial: cheeks + nose, chin and forehead Erythema, flushing, papules, pustules, telangiectasia Rhinophyma causes enlargement of the nose in some patients Sensitive skin Lesions in rosacea can approach the lips Pseudofolliculitis barbae Pseudofolliculitis barbae is most often associated with shaving Follicular papules, pustules, curled-in hair Perioral/periorificial dermatitis Pseudofolliculitis barbae Rosacea Face: erythema Erythema is less pronounced in dark skin Dermatomyositis Violaceous eyelids — may be swollen Poikiloderma on the trunk and limbs Gottron papules on fingers May have muscle weakness Flushing Intermittent redness when hot, embarrassed or with certain foods Often lifelong tendency Systemically well Associated with rosacea Sunburn Sun-exposed site Spares eyelids, furrows, under the chin Dermatomyositis Flushing Sunburn Systemic lupus erythematosus Butterfly erythematous rash Systemic symptoms: tiredness, lethargy, arthralgia Check CBC, ANA, ENA Telangiectasia May accompany flushing Vascular dilatation Various types Systemic LE Telangiectasia Face: brown macules/patches Pigmentation is more pronounced in dark skin Solar lentigines Sun-exposed sites Small to large freckles Well-demarcated flat or slightly scaly brown marks or thin plaques Erythema dyschromicum perstans Grey-brown discolouration Any distribution Distinct border, sometimes red at first Melasma Usually adult female Centrofacial, malar and mandibular patterns Spares eyelids, rare below jawline Symmetrical pigmentation with ragged border Post-inflammatory pigmentation Preceding eczema, psoriasis, acne etc Distribution depends on cause Erythema dyschromicum perstans Melasma Post-inflammatory pigmentation Face: pale or white macules/patches Guttate hypomelanosis More commonly observed on limbs Pityriasis alba Young child Cheeks Hypopigmentation, light scale Guttate hypomelanosis Forehead pityriasis alba Post-inflammatory hypopigmentation Preceding eczema, psoriasis, acne etc Distribution depends on cause Vitiligo Most often periocular, perioral White, smooth surface Post-inflammatory hypopigmentation Vitiligo Skin lesions Granuloma faciale Middle-aged adult Solitary thickened smooth, purplish-brown plaque or plaques Sarcoidosis Yellowish-brown to mauve infiltrated plaque May arise within existing scar Lupus pernio affects nose and ears Sebaceous hyperplasia Mostly > 40 years Forehead, temples Yellowish papules with central follicular dimple Sebaceous hyperplasia Granuloma faciale Sarcoidosis Solar comedones Smoker, sun damaged older patient Periocular, cheekbones, nose, neck Usually symmetrical Basal cell carcinoma Slowly enlarging, destructive papule, nodule or plaque Early erosion, ulceration and bleeding Squamous cell carcinoma Enlarging tender scaly or crusted nodule Solar comedones Basal cell carcinoma Squamous cell carcinoma Adnexal tumours Various types and syndromes Follicular or eccrine origin Milia Periorbital or cheeks Superficial firm small papules Scattered on forehead, cheeks Yellowish with central dell Birt-Hogg-Dubé syndrome Milia ADVERTISEMENT Other recommended articles TrendMD recommendations failed to load. 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Facial rashes
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Author: Hon A/Prof Amanda Oakley, Dermatologist, Hamilton, New Zealand, May 2016.
Erosions and crusting Dry or scaly rash Papulopustular rash Erythema Brown macules and patches Pale or white macules and papules Skin lesions
Patients often present with quite mild signs when they have a facial lesion or rash — due to embarrassment — and the diagnosis may be tricky.
Significant itch suggests atopic dermatitis or contact dermatitis.
Herpes simplex
Herpes zoster
Impetigo
Atopic eczema
Psoriasis
Seborrhoeic dermatitis
Contact eczema allergic
Contact eczema irritant
Photosensitive dermatitis
Actinic keratoses
Tinea faciei
Discoid lupus erythematosus
Lupus tumidus / Jessner lymphocytic infiltrate
Acne
Closed comedones
Perioral/periorificial dermatitis
Pseudofolliculitis barbae
Rosacea
Erythema is less pronounced in dark skin
Dermatomyositis
Flushing
Sunburn
Systemic LE
Telangiectasia
Pigmentation is more pronounced in dark skin
Erythema dyschromicum perstans
Melasma
Post-inflammatory pigmentation
Guttate hypomelanosis
Forehead pityriasis alba
Post-inflammatory hypopigmentation
Vitiligo
Sebaceous hyperplasia
Granuloma faciale
Sarcoidosis
Solar comedones
Basal cell carcinoma
Squamous cell carcinoma
Birt-Hogg-Dubé syndrome
Milia
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