8.1 Red Face

Grading & Level of Importance: B

ICD-11

None because the red face is a symptom.

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. 

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