Red Face

Synonyms

Facial erythema.

Epidemiology

Common skin symptom of several diseases, rosacea (81% of the patients with red face), atopic dermatitis, seborrhoeic dermatitis and many others.

Definition

Fixed or transient (flushing) red coloring of the face of different origins.

Aetiology & Pathogenesis

Minor temporary facial flushing: exogenous and endogenous physical and chemical stimuli.Major sign of clinically distinct entities, manifestation of particular skin diseases, sign of an internal disease (e.g. endocrine diseases).

Signs & Symptoms

In addition to erythema, other symptoms, such as warmth, oedema, infiltration, scaling, exudate, vesicles, crusts, lichenification and/or purple discolouration may occur depending on the aetiology in:

inflammatory skin diseases (facial allergic/toxic/irritant dermatitis, seborrheic dermatitis, facial psoriasis, acrodermatitis enteropathica, rosacea, lichen planus actinicus, erythroprosalgia).
infectious dermatoses (erysipelas, acrodermatitis chronica atrophicans, mycobacterial infections, primary herpes simplex, measles, fifth disease, tinea faciei).
vascular malformations.
rare dermatoses (keratosis pilaris atrophicans, ichthyoses, KID syndrome, photogenodermatoses, tuberous sclerosis).
sign of internal diseases/disorders/conditions (exercise, embarrassment, anger, stress, anxiety, guilt, pregnancy, perimenopause, heatstroke, sunburn, x-ray, UVB, wind, cold/heat exposure, sexual act, fever; cutaneous T-cell lymphoma, Hodgkin’s disease, hyperthyroidism, chronic oxygen deprivation, polycythaemia, pheochromocytoma, carcinoid tumor, carcinoid syndrome, systemic mastocytosis, collagen disorders, sarcoidosis).
drugs and toxins.
food ingestion.

Localisation

Entire face or certain pattern.

Classification

Temporary facial flushing.
Persistent red face.

Laboratory & other workups

Depending on the differential diagnosis.

Dermatopathology

Diagnosis-dependent.

Course

Transient, recurrent or permanent facial erythema.

Complications

Persistent facial erythema may result in several psychiatric disorders.

Diagnosis

Dependent on the facial- and extrafacial- localisation and classification of erythema, additional symptoms, history and results of skin biopsy and clinical and laboratory test.

Differential diagnosis

See above.

Prevention & Therapy

Depends on accurate diagnosis.

8.1 Red Face