Differential Diagnosis for Red Dry Pink Scaly Patches on Forehead and Nasal Folds

Single Most Likely Diagnosis

• Seborrheic Dermatitis: This condition is characterized by red, oily, flaky patches on the skin, particularly on the scalp, but also on oily areas of the body such as the face, including the forehead and nasal folds. It's a common condition that matches the described symptoms closely.

Other Likely Diagnoses

• Atopic Dermatitis (Eczema): Although more commonly associated with flexural areas, atopic dermatitis can present with dry, scaly patches on the face, including the forehead and around the nasal folds, especially in individuals with a history of allergies or asthma.
• Contact Dermatitis: This is a type of inflammation of the skin that occurs when the skin comes into contact with an irritant or allergen. It could present with red, dry, scaly patches on the forehead and nasal folds if the individual has been exposed to something they are allergic to or that irritates their skin in those areas.
• Rosacea: Characterized by redness, pimples, and in some cases, thickened skin, rosacea can also present with dry, scaly patches, particularly on the forehead and around the nasal area. However, it typically includes other symptoms like flushing and visible blood vessels.

Do Not Miss Diagnoses

• Lupus: Systemic lupus erythematosus (SLE) can cause a butterfly-shaped rash across the cheeks and nose, which might initially appear as red, dry, scaly patches. Missing this diagnosis could lead to significant morbidity due to the systemic nature of the disease.
• Sarcoidosis: This condition can cause skin lesions, including those on the face, which might appear as red, scaly patches. It's crucial not to miss sarcoidosis due to its potential to affect other organs, such as the lungs and eyes.

Rare Diagnoses

• Cutaneous T-Cell Lymphoma (Mycosis Fungoides): A rare type of skin cancer that can cause patches of skin to become red, dry, and scaly. It's essential to consider this in the differential, especially if the patches are persistent and not responding to typical treatments.
• Pityriasis Rubra Pilaris: A rare skin disorder that causes constant inflammation and scaling (exfoliation) of the skin. It can start with small, scaly patches on the face, including the forehead and around the nasal folds, before spreading to other parts of the body.