Facial rashes
Patients often present with fairly mild signs when they have a facial injury or eruption – due to embarrassment – and diagnosis can be tricky.
Significant itching suggests atopic dermatitis or contact dermatitis.
Expensive: erosions/ /crust
Herpes Simplex
- Monomorphic grouped vesicles or crusted papules
- often locally recurrent At the same place
- Swabs: Herpes simplex
Herpes infection
- Acute dermatomal eruption
- Painful: pain may precede the rash
- Erythema can precede vesicles
- Swabs: Shingles
Impetigo
- Irregular enlargement license plate
- honey-colored crusts
- Swabs: Staphylococcus aureus +/- Streptococcus pyogenes
Face: erosions/scabs
Herpes Simplex
Herpes infection
Impetigo
dry or scaly eruption
Seborrheic dermatitis
- Often also affects the scalp, postauricular sites, ears
- hairline, eyebrows, medium cheeks, nasolabial folds, chin wrinkles
- Squamous blepharitis
- Ill-defined, white or variable yellowish scales
- Can have erythematous patchy or thin plates
- Follicular follicular prominence or digitate keratosis
Psoriasis
- Eyelids, temples, retro and preauricular skin, and/or sites of seborrheic dermatitis
- It also affects the scalp, ears, elbows, knees, nail
- Well-demarcated erythematous plaques
- White scale
- More persistent than seborrheic dermatitis
Atopic eczema
- It often affects push-ups: retroauricular folds, elbows and knees
- Symmetrical eyelid dermatitis, perioral skin (up to the lips)
- intense itching
- Sharp flare: edemaerythema, crusts fissure
- Subacute: dry, pinkish
- Chronic: dryness, lichenification, Dennie Morgan creases (2 lower lid creases)
Face: scaly rash
Atopic eczema
Psoriasis
Seborrheic dermatitis
contact eczema
- Acute, recurrent/intermittent or chronic presentation.
- uneven, variable, unilateral or asymmetric dermatitis
- Sharp edge if contact irritating dermatitis
- Patch positive if contact allergy
Photosensitive dermatitis
- Exposed areas of face, arms, chest, legs.
- spare parts under hair, eyelids, folds
- Flashes after outdoor exposure
- Can be drug induced
Face: localized areas of dermatitis.
allergic contact eczema
irritant contact eczema
photosensitive dermatitis
Tinea faciei
- asymmetric eruption
- Cancel setting It is common
- scaly border
- positive mycology
Actinic keratosis
- Located in temple sites exposed to the sun, forehead, nose, cheekbones, jaw angle, upper lip, lower vermilion lip
- Persistent and tender scaly papules, maculesplates
Actinic keratosis
Tinea faciei
Tinea faciei
Cutaneous lupus erythematosus
Discoid lupus erythematosus
- Nose, cheeks, ears, lips, scalp
- Circumscribed plaques with follicular prominence, scale
- Send-inflammatory pigmentation, atrophic scars
- CBC, ANA, ENA often normal
Lupus tumidus / Jessner lymphocytic infiltrate
- Cheeks, upper trunk
- Smooth to erythematous surface dermal plates
Cutaneous lupus erythematosus
Discoid lupus erythematosus
Lupus tumidus / Jessner's lymphocytic infiltrate
papulopustular eruption
Acne
Acne
Closed comedones
- Onset often at puberty
- Usually symmetrical forehead, chin, side face nose
- Mixed inflammatory and non-inflammatory lesions
- papules, pustules, nodules, comedones
Oral /periorificial dermatitis
- Adult women usually wear expensive cream, often current corticosteroid
- Often asymmetric first at perioral sites, then at perinasal and periocular sites
- Save an inch of skin around the vermillion lips
- grouped erythematous papules and pustules in erythematous patches, scaly surface
- It can occur in children.
Rosacea
- Plus predominant in middle-aged adults
- Medium facial: cheeks + nose, chin and forehead
- Erythema, redness, papules, pustules, telangiectasia
- Rhinophyma causes enlargement of the nose in some patients.
- Sensitive skin
- Lesions may approach the lips.
Pseudofolliculitis of the beard
- Acne
- Follicular papules, pustules, curly hair.
Face: follicular eruption
Perioral / periorificial dermatitis
Pseudofolliculitis of the beard
Rosacea
Face: erythema
The erythema is less pronounced on dark skin.
Dermatomyositis
- Violaceous eyelids – may be swollen
- Poikiloderma on the trunk and extremities
- Gottron's papules on the fingers
- You may have muscle weakness.
Redness
- Intermittent redness when hot, embarrassed, or with certain foods.
- Often lifelong trend
- systemically well
- Associated with rosacea
Sun tanning
- site exposed to the sun
- Spare eyelids, furrows, under the chin.
Face: erythema
Dermatomyositis
Redness
Sun tanning
Systemic lupus erythematosus
- Erythematous butterfly rash
- Systemic symptoms: tiredness, lethargy, arthralgia
- Check CBC, ANA, ENA
Telangiectasia
- May accompany redness
- Vascular dilatation
- Various types
Systemic LE
Telangiectasia
Face: brown macules/patches
Pigmentation is more pronounced on dark skin.
Solar lentigines
- Sun-exposed sites
- small to large freckles
- Well-defined flat or slightly scaly brown marks or thin plaques
Erythema dyschromicum perstans
- Gray-brown discoloration
- None distribution
- Borde distintivo, a veces rojo al principio
Melasma
- Generalmente hembra adulta
- Centrofacial malar y patrones mandibulares
- Repuestos de párpados, poco frecuentes debajo de la línea de la mandíbula
- Pigmentación simétrica con borde irregular
Post-inflammatory pigmentation
- Eccema anterior, psoriasis, acné, etc.
- La distribución depende de la causa.
Face: brown patches
Erythema dyschromicum perstans
Melasma
Pigmentación posinflamatoria
Face: pale or white macules/patches
Guttate hypomelanosis
- Más comúnmente observado en las extremidades
Pityriasis Sunrise
- Little boy
- Las mejillas
- Hypopigmentation, escala de luz
Face: pale patches
Guttate hypomelanosis
Pitiriasis alba
Hipopigmentación posinflamatoria
- Eccema anterior, psoriasis, acné, etc.
- La distribución depende de la causa.
Vitiligo
- Muy a menudo periocular, perioral
- Superficie blanca y lisa
Face: white spots
Hipopigmentación posinflamatoria
Vitiligo
Skin lesions
Granuloma facial
- Adulto de mediana edad
- Placa o placas solitarias, espesas, lisas, de color marrón violáceo
Sarcoidosis
- Placa infiltrada de color marrón amarillento a malva
- Puede surgir dentro de los existentes scar
- El lupus pernio afecta la nariz y las orejas.
Sebaceous hyperplasia
- Mayormente> 40 años
- Frente, templos
- Pápulas amarillentas con hoyuelo folicular central.
Face: papules and plaques.
Sebaceous hyperplasia
Facial granuloma
Sarcoidosis
solar comedones
- Fumador, paciente mayor dañado por el sol
- Periocular, pómulos, nariz, cuello.
- Generalmente simétrica
Basal cell carcinoma
- Ampliación lenta, destructiva papule, nodule o placa
- Early erosion, ulceration and bleeding
Scaly cell carcinoma
- Agrandamiento del nódulo escamoso o con costras
Face: lesions
solar comedones
Basal cell carcinoma
Squamous cell carcinoma
Annexed tumors
- Varios tipos y síndromes
- Folicular o eccrine origen
Milia
- Periorbital o mejillas
- Firme superficial pápulas pequeñas
- Esparcidos en la frente, mejillas
- Amarillento con dell central
Face: multiple papules
Birt-Hogg-Dubé syndrome
Milia