Differential Diagnosis for Darkening with Bumpy Texture of Bilateral Lateral Cheek

• Single Most Likely Diagnosis
  • Melasma: This condition is characterized by patches of discoloration, typically on the face, and can present with a bumpy texture due to the uneven distribution of melanin. It's common in individuals with a history of sun exposure and hormonal changes.
• Other Likely Diagnoses
  • Keratosis Pilaris: A skin condition that causes rough, dry patches and can lead to a bumpy texture, often accompanied by hyperpigmentation, especially in areas like the cheeks.
  • Acne: Inflammatory acne can cause post-inflammatory hyperpigmentation (PIH), leading to dark spots, and the inflammation can result in a bumpy texture.
  • Eczema/Dermatitis: Conditions like atopic dermatitis or contact dermatitis can cause skin darkening and a bumpy texture due to inflammation and scratching.
• Do Not Miss Diagnoses
  • Skin Cancer: Although less likely, it's crucial not to miss skin cancers like melanoma, which can present with irregular pigmentation and texture changes. Early detection is vital for treatment outcomes.
  • Lupus: Systemic lupus erythematosus can cause a malar rash, which might appear as darkening with a bumpy texture on the cheeks, and is a condition that requires prompt diagnosis and management.
• Rare Diagnoses
  • Erythromelanosis Follicularis Faciei: A rare condition characterized by reddish-brown pigmentation and follicular papules, primarily affecting the cheeks.
  • Pigmented Contact Dermatitis: A variant of contact dermatitis that presents with hyperpigmentation, which can be accompanied by a bumpy texture, due to an allergic reaction to certain substances.