Differential Diagnosis for Red Blemishes on Cheeks
Single Most Likely Diagnosis
- Rosacea: This condition is characterized by redness, pimples, and in some cases, thickened skin on the face, particularly the cheeks. It can be triggered or worsened by heat, exercise, and other factors that cause blood vessels to dilate, making it a likely explanation for the symptoms described.
Other Likely Diagnoses
- Flushes associated with Carcinoid Syndrome: Although less common, carcinoid syndrome can cause flushing, particularly of the face, which can be triggered by various factors including heat and exercise. However, it's usually accompanied by other symptoms like diarrhea, wheezing, and heart valve abnormalities.
- Lupus Erythematosus: Systemic lupus erythematosus (SLE) can cause a butterfly-shaped rash across the cheeks, which may appear after sun or heat exposure. Exercise might not directly trigger it, but the condition's autoimmune nature and sensitivity to UV light make it a consideration.
- Erythema Infectiosum (Fifth Disease): Caused by parvovirus B19, this condition leads to a distinctive "slapped-cheek" appearance. While it's more common in children, adults can also be affected, and the rash can be triggered or worsened by heat or exercise, although this is less typical.
Do Not Miss Diagnoses
- Pheochromocytoma: A rare tumor of the adrenal gland that can cause episodic hypertension, sweating, tachycardia, and flushing. Although flushing is not always limited to the face, the potential severity of this condition (leading to hypertensive crises) makes it crucial not to miss.
- Medication-induced Flushing: Certain medications, such as vasodilators, can cause flushing as a side effect. This could be particularly noticeable on the cheeks and could be exacerbated by heat or exercise.
Rare Diagnoses
- Erythromelalgia: A disorder characterized by burning pain, heat, and redness in the hands and feet, but it can occasionally affect the face. It's rare and usually associated with other conditions like myeloproliferative disorders.
- Mitral Valve Prolapse: Some patients with mitral valve prolapse may experience atypical symptoms including flushing, but this is very rare and would typically be accompanied by other cardiac symptoms.