Differential Diagnosis for 31 yo Female with Anxiety and Dermatitis on the Chin and Face

• Single Most Likely Diagnosis
  • Atopic dermatitis (eczema): This is the most likely diagnosis given the patient's history of anxiety, which can exacerbate scratching behaviors, and the location of the dermatitis on the chin and face. Atopic dermatitis is a chronic inflammatory skin condition characterized by dry, itchy skin, and is often associated with other atopic diseases such as asthma and allergies.
• Other Likely Diagnoses
  • Contact dermatitis: This could be a possible diagnosis if the patient has been exposed to irritants or allergens on her chin and face, such as certain skincare products, makeup, or metals.
  • Seborrheic dermatitis: This condition causes a red, itchy rash, typically on the scalp, but can also occur on the face, especially in areas with high oil production like the nose and chin.
  • Psoriasis: Although less common on the face, psoriasis can cause red, scaly patches and can be exacerbated by stress and anxiety.
• Do Not Miss Diagnoses
  • Lupus: Systemic lupus erythematosus (SLE) can cause a butterfly-shaped rash on the face, and while it's less likely, missing this diagnosis could have serious consequences due to the potential for systemic involvement.
  • Sarcoidosis: This condition can cause skin lesions, including on the face, and is important not to miss due to its potential to affect other organs like the lungs and eyes.
• Rare Diagnoses
  • Dermatomyositis: An autoimmune condition that can cause skin rash and muscle weakness, with facial involvement being possible.
  • Cutaneous T-cell lymphoma (Mycosis fungoides): A rare type of skin cancer that can cause patches, plaques, or lesions on the skin, including the face, though it's much less common and typically presents in older adults.