Differential Diagnosis for Facial Fungal Rash
The following differential diagnosis is organized into categories to help guide the thought process:
- Single most likely diagnosis
- Intertrigo (Candidal Intertrigo): This is the most likely diagnosis due to the location of the rash (nasal labial folds and outer corners of the lips), which are warm, moist areas prone to fungal infections. Intertrigo is a type of fungal infection that thrives in these conditions.
- Other Likely diagnoses
- Seborrheic Dermatitis: This condition can cause a rash in the facial area, including the folds around the nose and mouth. It's characterized by a red, itchy, and flaky skin rash.
- Perleche (Angular Cheilitis): This condition affects the corners of the mouth and can be caused by fungal infections, among other factors. It presents with redness, cracking, and discomfort.
- Impetigo: A highly contagious bacterial infection that can cause a rash around the mouth and nose. It's more common in children but can occur in adults.
- Do Not Miss (ddxs that may not be likely, but would be deadly if missed.)
- Lupus: Systemic lupus erythematosus (SLE) can cause a butterfly-shaped rash across the cheeks and nose, which might be mistaken for a fungal infection. Missing this diagnosis could lead to severe consequences due to the systemic nature of lupus.
- Sarcoidosis: This condition can cause skin lesions and rashes, including on the face. It's an autoimmune disease that can affect multiple organs, making early diagnosis crucial.
- Rare diagnoses
- Histoplasmosis: A rare fungal infection that can cause skin lesions, among other symptoms. It's more common in people with weakened immune systems.
- Paracoccidioidomycosis: Another rare fungal infection that can cause skin lesions, particularly in the facial area. It's more prevalent in certain regions of Central and South America.
Treatment for the most likely diagnosis, Intertrigo (Candidal Intertrigo), typically involves keeping the affected area clean and dry, and using an antifungal cream or ointment. In severe cases, oral antifungal medications may be prescribed. For other conditions, treatment will vary based on the specific diagnosis.