Differential Diagnosis for Temporal Indurated Facial Swelling
Single Most Likely Diagnosis
- Sylvatic or Sycosis Barbae: This is a type of folliculitis that occurs in the beard area, often after shaving. The lack of erythema and warmth, combined with the history of shaving and exfoliating, makes this a plausible diagnosis. However, the location at the sideburns (temporal area) is slightly atypical, as sycosis barbae more commonly affects the chin and neck area.
Other Likely Diagnoses
- Folliculitis: Similar to sycosis barbae but not limited to the beard area, folliculitis can occur anywhere on the body where hair follicles are present, including the temporal region. It's caused by bacterial infection, often due to Staphylococcus aureus, and can be triggered by shaving or exfoliating.
- Ingrown Hair (Pseudofolliculitis Barbae): This condition occurs when hairs curl back into the skin, causing inflammation. It's common in areas where the hair is curly and the skin is shaved, which could include the sideburn area.
- Contact Dermatitis: An allergic reaction or irritation from shaving cream, aftershave, or exfoliating products could cause swelling and induration without significant erythema or warmth, especially if the reaction is more towards an irritant contact dermatitis.
Do Not Miss Diagnoses
- Cellulitis: Although the absence of erythema and warmth makes this less likely, cellulitis can present atypically, especially in its early stages or in immunocompromised patients. It's a bacterial infection of the skin and subcutaneous tissues that requires prompt antibiotic treatment.
- Parotid Gland Infection or Abscess: Infections of the parotid gland can cause swelling in the temporal area. While typically accompanied by more systemic symptoms and localized signs of infection, atypical presentations can occur.
- Lymphadenitis: Inflammation of the lymph nodes, which could be due to infection or other causes, might present as swelling in the temporal area if the lymph nodes involved are located there.
Rare Diagnoses
- Granuloma Faciale: A rare, chronic inflammatory condition that can cause single or multiple nodules on the face, typically on the forehead, but could potentially occur in the temporal area.
- Sarcoidosis: A systemic disease that can cause granulomatous inflammation in various parts of the body, including the skin. Facial swelling could be a manifestation, although it would typically be part of a broader constellation of symptoms.
- Lupus Miliaris Faciei: A rare, chronic granulomatous condition of the face, which could potentially cause indurated lesions in the temporal area, although it's more commonly seen on the cheeks and forehead.