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Background
A red rash on the face in an adult patient is a common presentation to general practice in Australia. Rashes on the face significantly affect quality of life because this is a cosmetically sensitive site. Ascertaining the correct diagnosis is therefore of utmost importance so that appropriate treatment can be initiated.
Objective
This article discusses the assessment of red rashes on the face in an adult patient.
Discussion
Diagnosing a red rash on the face requires assessment of symptomology, age of onset, rash morphology and 'clinical clues' that help delineate between differentials. Although the list of differential diagnoses is wide, many of the common diagnoses can be made clinically without the need for investigations. Investigations such as skin biopsy are useful if the diagnosis is unclear, if the rash is not responding to initial treatment and/or a referral to a dermatologist is being considered.
A RED RASH ON THE face in an adult patient is a common presentation to primary care. A thorough clinical assessment is often able to delineate between common causes. In undifferentiated rashes, investigations such as skin biopsy, skin scrapings and swabs might be helpful.
Aim
This article discusses the assessment of red rashes on the face in adults.
Assessment of red facial rashes
Red rashes on the face have a wide differential diagnosis. Assessment of these patients requires a thorough history and examination. Many of the common diagnoses can be made clinically without the need for investigations.
Differential diagnosis
A red rash on the face can be due to an underlying dermatological condition or infection, or it could be triggered by exogenous factors (Table 1). These causes can be differentiated by assessing the typical age of onset, distribution and morphology (Table 2).
Approach to red rash on the face in adults
An efficient method of assessing a red rash on the face in adults is to take a history of the rash, followed by a clinical examination, and to then ask targeted questions based on examination findings (ie 'clinical clues') to help differentiate between remaining possible diagnoses (Figure 1). An assessment of rash morphology allows the clinician to narrow the differential diagnoses (Figure 2).
History of presenting issue
The history would ideally begin with open-ended questions that help clarify the...