Differential Diagnosis for Red Pus-Filled Papules on Cheeks
Single Most Likely Diagnosis
- Rosacea: This condition is characterized by red, pus-filled papules on the face, particularly on the cheeks, and is common in adults. The patient's age and the description of the lesions make rosacea a strong candidate.
Other Likely Diagnoses
- Acne Vulgaris: Although more common in younger individuals, acne can persist into adulthood. The presence of pus-filled papules on the cheeks could suggest acne, especially if the patient has a history of the condition.
- Folliculitis: An infection of the hair follicles, folliculitis can present with red, pus-filled papules and is a plausible diagnosis given the location and description of the lesions.
- Perioral Dermatitis: This condition presents with small, red, pus-filled papules around the mouth and can extend to the cheeks. It's more common in women but can occur in men.
Do Not Miss Diagnoses
- Lupus Miliaris Disseminatus Faciei (LMD): A rare form of cutaneous lupus, LMD can present with small, reddish-brown, pus-filled papules on the face. Although less common, missing this diagnosis could lead to significant morbidity due to its association with systemic lupus erythematosus.
- Sarcoidosis: This systemic disease can manifest with skin lesions, including papules, and although rare, its diagnosis is critical due to its potential for serious systemic involvement.
- Infectious Diseases (e.g., Staphylococcal or Streptococcal Infections): Bacterial infections can cause pus-filled lesions and, depending on the causative agent, may require urgent treatment to prevent serious complications.
Rare Diagnoses
- Demodex Folliculitis: Caused by the Demodex mite, this condition can lead to follicular-based papules and pustules, particularly in immunocompromised individuals or those with poor hygiene.
- Erythema Elevatum Diutinum: A rare skin condition characterized by red, pus-filled papules, often on the extensor surfaces but can appear on the face, associated with various systemic diseases.
- Granuloma Faciale: A rare, chronic condition presenting with single or multiple, reddish-brown, soft plaques or nodules on the face, which can resemble pus-filled papules.