Differential Diagnosis for Closed Flash Burn to Cheeks Causing Tan Darkened Skin

• Single Most Likely Diagnosis
  • Flash burn (also known as erythema ab igne or flash sunburn): This is the most likely diagnosis given the context of a closed flash burn, which can cause immediate damage to the skin, leading to darkened, tan skin due to the intense heat.
• Other Likely Diagnoses
  • Chemical burn: Exposure to certain chemicals can cause skin darkening and burns, although the history would typically involve contact with a caustic substance rather than a flash burn.
  • Thermal burn from other sources: Burns from other heat sources (like flames, hot surfaces, or steam) could also result in similar skin changes, depending on the severity and duration of exposure.
  • Sunburn: Prolonged exposure to UV radiation can cause sunburn, which might present with darkened skin, especially in individuals with fair skin.
• Do Not Miss Diagnoses
  • Electrical burn: Although less common, electrical burns can cause deep tissue damage with minimal external signs, including darkening of the skin. It's crucial to consider this diagnosis due to potential internal injuries.
  • Radiation exposure: Certain types of radiation exposure can cause skin burns and darkening, which would be critical to identify due to the potential for severe health consequences.
• Rare Diagnoses
  • Berloque dermatitis: A rare condition caused by certain fragrances in perfumes and cosmetics that react with sunlight to cause skin darkening.
  • Fixed drug eruption: A condition where certain medications cause skin lesions that can darken upon re-exposure to the drug, although this would not typically be associated with a flash burn.
  • Melasma: A condition characterized by patches of discoloration, typically on the face, but it's not directly related to burns and would have a different presentation and history.