facial rashes

see also:

• dermatology
• non-traumatic facial swelling / oedema
• DermNet NZ: facial rashes index

• herpes zoster (shingles) - dermatomal to one side only
• Herpes simplex virus (HSV)
• 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
• malar rash of systemic lupus erythematosus (SLE)
• slapped cheek phase of Fifth disease in children
• acne rosacea - although may involve neck and upper chest and may present acutely

• see acne rosacea

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

• 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
• see DermNet NZ

• 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

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

• face is a common site as it is exposed to light
• examples include:
  • polymorphic light eruption
  • solar urticaria
  • drug induced
  • contact induced
  • porphyrias
• note many dermatoses are also exacerbated by light exposure such as:
  • systemic lupus erythematosus (SLE)
  • acne rosacea
  • psoriasis
  • atopic_dermatitis
  • dermatomyositis
  • pemphigus
• see DermNet NZ

• 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
• see DermNet NZ

• 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
• see DermNet NZ

• see seborrheic 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
• see DermNet NZ

• 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
• see DermNet NZ

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

• 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
• see DermNet NZ

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

• see systemic lupus erythematosus (SLE)
• 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

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

• see 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
• see DermNet NZ

• chronic, recurrent exfoliative pruritic rash with dry skin +/- papulo-pustules affecting various areas of body but commonly on face but sparing nose and peri-oral region
• recurrences can continue for up to 5 yrs after ceasing topical steroids although most cease after several months.

• a hyper-reactive state of the skin, primarily on the face.
• associated with impaired function of the epidermal barrier, increased permeability of the skin, and high loss of water through the skin (transepidermal water loss) which may be associated with a thinner outermost layer (stratum corneum)
  • a compromised epidermal barrier allows irritants or allergens to penetrate the skin, inadequately protects nerve endings, and increases transepidermal water loss
• accompanied by subjective symptoms such as burning, stinging, itching, and tightness when exposed to physical, chemical, or psychological stimuli.
• aka Cosmetic Intolerance Syndrome (CIS)
• subjectively appears to affect 2/3rds of adults, with over 1/3rd saying they have moderate to severe symptoms¹⁾
• some may have erythema, scales, and dilated blood vessels.

• 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