Face Plaques

A firm plaque on the face could be localised morphea,lupus erythematosus profundus,a deep fungal infection,cellulitis,eosinophilic cellulitis or Well's disease,insect bite reaction,localised lymphoma,infiltrating basal cell skin cancer,non lupus panniculitis,granuloma faciale,lymphocytoma,angiosarcoma or Kimura's disease.There is no easy way to make a definitive diagnosis in these cases without doing a skin biopsy.

Management-The important thing is to do a deep biopsy to pick up pathology in the deeper layers of the skin including the fat.

 

SIGN DIP Overview of Plaques

Plaques are essentially grouped papules that coalesce or they are infiltrates or deposits in the skin.So many of the papular disorders can form plaques and many of the nodular disorders have the same differentials.

S Squamous Psoriasis,Pityriasis rubra pilaris,Tinea barbae,Epidermal nevus,Sebaceous nevus,Discoid lupus

I Infective   Deep fungus,Tinea barbae,Leishmaniasis,Tuberculosis,Leprosy,  Acanthameba,  Post erysipelas ,Cellulitis ,Post rosacea,Plasma cell balanitis,   

G Granulomatous Actinic granuloma,Granuloma annulare,Necrobiosis lipoidica,Granuloma faciale,Erythema elevatum diutinum,Sarcoidosis

N Neoplastic Mycosis fungoides,Basal cell skin cancer,Paget’s and extramammary Paget’s disease,Lymphocytoma,Lymphoma,Jessners lymphocytic infiltrate,Parapsoriasis,Mycosis fungoides,Metastases,Kimura's disease,Angiosarcoma,Follicular mucinosis,Amyloidosis,

D Drug Sclerosant injection,Fixed drug reaction,Vitamin K injection,

I Immunological  Urticaria,Discoid lupus erythematosus,Lupus panniculitis,Localised morphea,Scleredema,Scleroderma,Eosinophilic fasciitis,Eosinophilic cellulitis,Urticarial vasculitis,

P Physical  Post traumatic,Polymorphous light eruption,Chronic actinic dermatitis

Syndromes Blooms syndrome,Familial mediteranean fever,Reticular erythematous mucinosis,Sweet’s syndrome,Well’s syndrome,Erythema elevatum diutinum,