Differential Diagnosis for Red Itchy Burning Rash to Face that Peels

• 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 a red, itchy, and sometimes burning rash. The peeling aspect can be part of the healing process. Given the location on the face, common culprits could include new skincare products, makeup, or environmental exposures.
• Other Likely Diagnoses
  • Seborrheic Dermatitis: Characterized by a red, itchy, and flaky rash, often on the face, particularly in areas rich with sebaceous glands like the nose and eyebrows. It can cause peeling and has a tendency to flare and remit.
  • Atopic Dermatitis (Eczema): Although more common in children, atopic dermatitis can occur at any age and may present with red, itchy, and sometimes burning patches on the face. Peeling can occur, especially after the acute phase.
  • Rosacea: This condition can cause redness, itching, and burning sensations on the face. While peeling is not its hallmark, some subtypes of rosacea can lead to skin that feels tight and may peel, especially after flare-ups or certain treatments.
• Do Not Miss Diagnoses
  • Lupus: Systemic lupus erythematosus (SLE) can cause a malar rash (butterfly-shaped rash across the cheeks) that may be itchy, burn, and peel. Missing this diagnosis could lead to significant morbidity due to untreated SLE.
  • Sjögren's Syndrome: An autoimmune disorder that can cause skin rashes, including on the face, which might be accompanied by itching, burning, and peeling. It's crucial not to miss this diagnosis due to its potential to cause systemic symptoms and complications.
• Rare Diagnoses
  • Pemphigus: A group of rare skin disorders that cause blistering of the skin and mucous membranes. While not typically the first consideration for a red, itchy, burning rash that peels, pemphigus can present with skin peeling and should be considered in severe or refractory cases.
  • Staphylococcal Scalded Skin Syndrome (SSSS): Caused by staphylococcal toxins, SSSS leads to widespread skin peeling, redness, and can start on the face. It's more common in children but can occur in adults, especially those with compromised immune systems. It's a medical emergency due to the risk of severe dehydration and sepsis.