Differential Diagnosis for Rash on Left Upper and Lower Eyelids

Single Most Likely Diagnosis

• Contact Dermatitis: This is a common condition that occurs when the skin comes into contact with an irritant or allergen, leading to inflammation and a rash. The eyelids are a sensitive area, and exposure to new cosmetics, soaps, or other products can easily cause a reaction.

Other Likely Diagnoses

• Atopic Dermatitis (Eczema): This chronic skin condition can cause itchy, inflamed skin and is common on the face, including the eyelids. It often starts in childhood but can persist into adulthood.
• Blepharitis: An inflammation of the eyelids that can cause redness, itching, and a rash. It's often associated with rosacea or seborrheic dermatitis.
• Seborrheic Dermatitis: A skin condition that can cause a rash, often on oily areas of the body like the face. It can affect the eyebrows and eyelids, leading to redness and flaking skin.

Do Not Miss Diagnoses

• Herpes Zoster (Shingles): Although less common, shingles can cause a painful rash on one side of the face, including the eyelids. It's crucial to diagnose and treat promptly to prevent complications like vision loss.
• Lupus: Systemic lupus erythematosus can cause a butterfly-shaped rash across the cheeks and nose but can also affect the eyelids. Missing this diagnosis could lead to delayed treatment of a serious autoimmune disease.
• Sarcoidosis: A condition that can cause inflammation in various parts of the body, including the skin. It might present with a rash on the face, including the eyelids, and is important not to miss due to its potential to affect other organs.

Rare Diagnoses

• Dermatomyositis: An inflammatory disease that can cause skin rash and muscle weakness. The rash can appear on the face, including the eyelids, and is often accompanied by other systemic symptoms.
• Granuloma Faciale: A rare skin condition that causes nodules or plaques, typically on the face, which can include the eyelids. It's more common in men and can be challenging to treat.
• Angioedema: A condition characterized by the rapid swelling of the skin and mucous membranes, which can sometimes present with a rash. It can be life-threatening if not recognized and treated promptly, especially if it involves the airways.