Differential Diagnosis for 44-year-old Female with Facial Rash
- Single most likely diagnosis
- Rosacea: Given the patient's history of acne and the description of the rash as red, scaly, and burning, concentrated on the forehead and cheeks, rosacea is a strong consideration. The patient's age and the absence of any recent changes in detergents, soaps, or creams also support this diagnosis.
- Other Likely diagnoses
- Contact dermatitis: Although the patient denies any changes in detergents, soaps, or creams, contact dermatitis remains a possibility, especially if she has started using a new product without realizing it or if she has been exposed to an allergen or irritant.
- Seborrheic dermatitis: The scaly nature of the rash and its concentration on the forehead and cheeks could also suggest seborrheic dermatitis, a common condition in adults.
- Sarcoidosis flare: Given the patient's history of sarcoidosis, a flare of the disease could potentially cause a skin rash, although the description provided does not strongly suggest this as the primary diagnosis.
- Do Not Miss (ddxs that may not be likely, but would be deadly if missed)
- Lupus erythematosus: Although less likely, systemic lupus erythematosus (SLE) can cause a malar rash (butterfly-shaped rash across the cheeks) and should be considered, especially given the patient's autoimmune history with sarcoidosis.
- Erythema multiforme: This is a skin condition characterized by target lesions and can be triggered by infections or medications. It's crucial to consider due to its potential severity and the patient's recent antibiotic use.
- Rare diagnoses
- Sjögren's syndrome: An autoimmune disorder that could potentially cause skin rashes among other symptoms, though it is less likely given the information provided.
- Dermatomyositis: An inflammatory disease characterized by skin rash and muscle weakness, which would be an unusual presentation given the patient's symptoms and history.