Differential Diagnosis for Blotchy Rash on Cheeks when Nursing

• Single most likely diagnosis
  • Contact dermatitis: This is a common condition that can occur due to skin irritation from saliva, spit-up, or other substances that come into contact with the skin while nursing. The rash is often seen on the cheeks and chin.
• Other Likely diagnoses
  • Atopic dermatitis (eczema): This is a chronic skin condition that can cause a blotchy rash on the cheeks, especially in individuals with a history of allergies or asthma.
  • Seborrheic dermatitis: This condition can cause a red, blotchy rash on the face, including the cheeks, and is often seen in areas with high oil production.
  • Acne: Hormonal changes during nursing can lead to acne, which can manifest as a blotchy rash on the cheeks.
• Do Not Miss (ddxs that may not be likely, but would be deadly if missed.)
  • Lupus: Although rare, systemic lupus erythematosus (SLE) can cause a characteristic "butterfly" rash on the cheeks, which may be exacerbated by nursing.
  • Sarcoidosis: This condition can cause skin lesions, including a blotchy rash on the cheeks, and requires prompt diagnosis and treatment.
• Rare diagnoses
  • Dermatomyositis: This is an autoimmune condition that can cause a distinctive rash on the cheeks, as well as muscle weakness.
  • Erythema multiforme: This is a rare skin condition that can cause a target-shaped rash on the cheeks and other areas of the body.