Differential Diagnosis for Rash on Face Tender to Touch for 6 Weeks
Single Most Likely Diagnosis
- Rosacea: A chronic skin condition characterized by inflammation, redness, and acne-like symptoms on the face. The tenderness to touch and the location on the face make rosacea a strong candidate, given its prevalence and the described symptoms.
Other Likely Diagnoses
- Contact Dermatitis: An allergic or irritant reaction to something that has come into contact with the skin, leading to redness, itching, and tenderness. Given the face's exposure to various products and environmental factors, this is a plausible diagnosis.
- Acne: Especially inflammatory acne, which can cause tender red bumps on the face. The duration and tenderness suggest a more severe form of acne.
- Eczema (Atopic Dermatitis): Characterized by itchy, inflamed skin, which can sometimes be tender to the touch. Facial involvement is less common in adults but can occur, especially in those with a history of atopic diseases.
Do Not Miss Diagnoses
- Lupus: Systemic lupus erythematosus can cause a butterfly-shaped rash across the cheeks and nose, which can be tender. Missing this diagnosis could lead to significant morbidity due to the systemic nature of the disease.
- Cellulitis: A bacterial skin infection that can cause redness, swelling, and tenderness. It requires prompt antibiotic treatment to prevent serious complications.
- Sarcoidosis: A condition that can cause skin lesions, among other systemic symptoms. Facial involvement can include tender rashes or nodules.
Rare Diagnoses
- Sjögren's Syndrome: An autoimmune disorder that can cause skin rashes, among other symptoms like dry eyes and mouth. While less common, it's a consideration in chronic cases with systemic symptoms.
- Dermatomyositis: An inflammatory disease characterized by skin rash and muscle weakness. The facial rash can be tender and is often accompanied by other specific skin changes and muscle symptoms.
- Granuloma Faciale: A rare skin condition causing nodular or plaque-like lesions on the face, which can be tender. It's less common but should be considered in cases not responding to typical treatments for more common conditions.