Differential Diagnosis of Central Papulopustular Lesions on Erythematosus Base of Face
Single Most Likely Diagnosis
- Acne vulgaris: This is the most common condition presenting with central papulopustular lesions on an erythematosus base, particularly on the face. It is characterized by comedones, papules, pustules, and sometimes cysts and nodules, primarily affecting the sebaceous areas of the face.
Other Likely Diagnoses
- Rosacea: Characterized by central facial erythema, telangiectasias, and papulopustular lesions. It can be distinguished from acne by the absence of comedones and the presence of flushing and telangiectasias.
- Perioral dermatitis: Presents with papulopustular lesions around the mouth, which can extend to the central face. It is often associated with the use of topical corticosteroids or other irritants.
- Folliculitis: An inflammatory condition of the hair follicles, which can present with papulopustular lesions, especially in areas with dense hair follicles like the face.
Do Not Miss Diagnoses
- Lupus miliaris disseminatus faciei (LMDF): A rare condition that can mimic acne or rosacea but is actually a form of cutaneous lupus. It presents with small, reddish-brown papules on the face.
- Sarcoidosis: Can present with papulopustular lesions on the face, among other systemic symptoms. It's crucial to consider this diagnosis due to its potential for systemic involvement.
- Demodex folliculitis: Caused by the Demodex mite, which can lead to papulopustular lesions, especially in immunocompromised patients or those with poor hygiene.
Rare Diagnoses
- Granulomatous rosacea: A variant of rosacea characterized by granulomatous papules and nodules.
- Erythema elevatum diutinum: A rare condition presenting with papulopustular lesions, typically on the extensor surfaces but can involve the face, associated with systemic diseases like HIV or hematological disorders.
- Neutrophilic dermatoses (e.g., Sweet syndrome, pyoderma gangrenosum): Although rare, these conditions can present with papulopustular lesions and are associated with systemic symptoms or underlying diseases.