Differential Diagnosis for Recurrent Facial Rash in a Teen
- Single most likely diagnosis
- Acne: This is the most common skin condition in teenagers, characterized by comedones, papules, pustules, and sometimes cysts, often on the face. The recurrent nature and facial location make acne a highly probable diagnosis.
- Other Likely diagnoses
- Rosacea: A chronic skin condition that causes redness, pimples, and swelling of the face, often triggered by factors like sun exposure, stress, or certain foods. It's common in teenagers and can be mistaken for acne.
- Contact Dermatitis: An allergic or irritant reaction to substances like makeup, skincare products, or metals (e.g., nickel in jewelry), leading to a rash that can recur if the allergen or irritant is not avoided.
- Eczema (Atopic Dermatitis): Although more common in younger children, eczema can persist into or even start in adolescence, causing recurrent itchy, inflamed skin rashes that can appear on the face.
- Do Not Miss (ddxs that may not be likely, but would be deadly if missed.)
- Lupus: Systemic lupus erythematosus (SLE) can cause a butterfly-shaped rash across the cheeks and nose, among other symptoms. It's an autoimmune disease that can be severe and requires early diagnosis and treatment.
- Sarcoidosis: A condition where inflammatory cells form lumps known as granulomas in various parts of the body, including the skin, which can cause facial rashes. It can affect multiple organs and requires prompt diagnosis.
- Rare diagnoses
- Dermatomyositis: An inflammatory disease characterized by skin rash and muscle weakness, which can present with a distinctive facial rash. It's rare and can be associated with underlying malignancies or autoimmune disorders.
- Sjögren's Syndrome: An autoimmune disorder that can cause skin rashes among other symptoms like dry eyes and mouth. It's less common and might be considered if other symptoms are present.
- Granuloma Faciale: A rare skin condition that causes persistent, single or multiple, red-brown facial plaques or nodules, typically on the forehead, cheeks, or nose. It's benign but can be disfiguring and resistant to treatment.