Differential Diagnosis for Dry Red Patches Surrounding Mouth, Eyes, and on Sides of Nose and Folds

Single Most Likely Diagnosis

• Atopic Dermatitis (Eczema): The description of dry red patches surrounding the mouth, eyes, and on the sides of the nose and folds is highly suggestive of atopic dermatitis, especially given the common areas affected. Eczema is a chronic condition characterized by inflammation and dryness of the skin, often presenting with such symptoms.

Other Likely Diagnoses

• Seborrheic Dermatitis: This condition can cause red, oily, flaky patches on the skin, particularly on the scalp, but it can also affect areas around the nose and eyes. The presence of dryness and redness in these areas could suggest seborrheic dermatitis, especially if there's a history of similar skin issues.
• Contact Dermatitis: This is a type of skin inflammation caused by contact with irritants or allergens. Given the specific areas affected (around the mouth, eyes, and sides of the nose), it's possible that the patient has come into contact with a substance that's causing a reaction, leading to the observed symptoms.
• Perioral Dermatitis: Characterized by redness and small bumps around the mouth, perioral dermatitis could be considered if the primary area of concern is around the mouth, though it less commonly involves the eyes and sides of the nose.

Do Not Miss Diagnoses

• Lupus: Systemic lupus erythematosus (SLE) can cause a butterfly-shaped rash across the cheeks and nose, which might initially resemble the described symptoms. Although less common, missing a diagnosis of lupus could have significant consequences due to its systemic nature and potential for serious complications.
• Sarcoidosis: This condition can cause skin lesions, among other symptoms, and while less likely, it's crucial not to miss due to its potential to affect multiple organ systems.

Rare Diagnoses

• Graft-Versus-Host Disease (GVHD): In individuals who have undergone bone marrow or stem cell transplants, GVHD can cause skin symptoms that might resemble eczema or dermatitis, including redness and dryness in various areas of the body.
• Pellagra: A condition caused by niacin deficiency, pellagra can lead to dermatitis, among other symptoms. The dermatitis associated with pellagra can appear similar to eczema, especially if it involves sun-exposed areas and areas around the mouth.