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rash_facial

facial rashes

acute rashes only affecting the face

  • herpes zoster (shingles) - dermatomal to one side only
  • angular cheilitis
  • circum-oral irritant dermatitis from saliva
  • tinea corporis may just involve the face
  • molluscum contagiosum may just involve an area of the face
  • slapped cheek phase of Fifth disease in children
  • acne rosacea - although may involve neck and upper chest and may present acutely

chronic dermatoses mainly affecting the face

rosacea

acne vulgaris

  • common in post-pubertal people
  • characterised by oily skin, papules and pustules with blackheads

atopic eczema

  • a chronic, dry, scaly, itchy skin condition that is very common in children but may occur at any age
  • affects 15-20% of children, with onset usually between 4 months age to 2 years age, and is often most severe in 2-4 year olds
  • older children tend to have a flexural pattern in elbow and knee creases and also eyelids, earlobes, neck and scalp

keratosis pilaris rubra faciei

  • a common chronic rough, follicular, erythematous rash mainly on the cheeks, but is often also on the upper arms
  • most common in adolescent years, especially in those who are overweight or have atopic eczema or ichthyosis
  • often worse in winter or during low humidity
  • laser Rx may help reduce the erythema
  • see also DermNet NZ

contact dermatitis

  • irritant dermatitis may be due to saliva (eg. habitual mouth licking), facial creams, etc
  • Rx is to remove the irritant +/- topical steroids

photodermatoses

pyoderma faciale

  • an unusual skin condition occurring in young adult women
  • starts abruptly and rarely lasts more than a year
  • unlike acne rosacea, is not associated with flushing
  • does not affect the eyes

perioral dermatitis

  • papules around the mouth
  • may spread to around nose, eyelids, anus or genitalia
  • mainly affects adult women and may be related to hormonal changes or OCPs
  • it may be a variant of acne rosacea and may be caused by topical steroids, including nasal steroids, or other facial creams and cosmetics

seborrhoeic dermatitis

  • tends to occur after puberty
  • causes dandruff, blepharitis and scaliness in the ears, and in creases of the nose
  • can also occur in armpits, etc
  • thought to be an inflammatory reaction to a yeast called Malassezia
  • can be aggravated by stress, fatigue, ill-health, alcohol abuse, immunocompromise
  • Rx with antifungal agents and intermittent topical steroids

facial psoriasis

  • one or more, persistent, thickened, red and dry patches on the face
  • most patients also have scalp psoriasis
  • 3 main subtypes:
    • hairline psoriasis
    • sebo-psoriasis - affects eyelids, eyebrows, nasolabial folds and beard area
    • true facial psoriasis - sharply demarcated, red, scaly plaques, often symmetrical

pityriasis alba

  • mainly cheeks of children with round or oval slightly scaly pink patches appear, leaving pale marks
  • resolves in months usually

Poikiloderma of Civatte

  • pigmentation and ageing skin creases affecting the sun-exposed lower neck of women with fair skin which has been sensitised by use of perfumes, etc

actinic keratoses

  • mainly middle-aged or elderly who have fair skin or worked outdoors

lupus

  • eg. discoid LE predominantly affects the cheeks, nose and ears, but sometimes involves the upper back, V of neck, and backs of hands
  • cutaneous LE mainly affects women aged 20-50yrs and is often exacerbated by sun exposure and smoking
  • see DermNet NZ for the many types of cutaneous lupus

Jessner lymphocytic infiltrate

  • non-scaly red patches and lumps on the face, neck and upper back

sarcoidosis

  • mainly affects people between 20-40 years of age
  • facial lesions include:
    • lupus pernio: large bluish-red and dusky purple infiltrated nodules and plaque-like lesions on nose, cheeks, ears, fingers and toes
    • granulomata
    • inflamed eyes

seborrhoeic distribution

  • ie. involving mainly the seborrhoeic areas of the face (scalp margins, forehead, ears, around the nostrils and sides of nose, eyebrows, and beard area)
  • seborrhoeic dermatitis
  • Darier disease
rash_facial.txt · Last modified: 2022/07/15 06:48 by gary1

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