Face Red Scaly

 If a rash is red and scaly you use the mnemonic PMs PETAL (PET is Psoriasis, Eczema and Tinea. This is the Prime Minister's Pet ( I used to always think of Kevin Rudd with a siamese cat called Petal sitting on his lap!) The first P of PM is for Pityriasis rosea or Pityriasis versicolor and rarely Pityriasis rubra pilaris and Pityriasis lichenoides. This P can also stand for Pharmaceutical because drugs can cause red scaly rashes and the M is for Mycosis fungoides, a T cell lymphoma of the skin.) The little s is for Solar, Scabies, Syphilis and Syndromes (eg Dariers and Grovers and CIE Congenital ichthyosiform erythroderma) that can rarely present as a red scaly rash. Never forget solar in Australia particularly Porokeratoses or SCC in situ on the legs looking like psoriasis. View red scaly rashes
Now we know that his pet cat is called PETAL. This helps us to remember Psoriasis, Eczema and Tinea but also the less common red scaly diseases of A for Annular erythemas and L for Lupus erythematosus ,Lichen Planus, Light eruption and Lues (an old name for syphilis)

Red scaly rashes on the face are typically due to sun damage in a white population followed by atopic or contact eczema,seborrhoeic eczema,tinea facei,and discoid lupus erythematosus.The latter can closely mimic sun damage.Steroid modified tinea infections may not have the typical scaly edge you associate wth fungal infections..

Red scaly rashes in the scalp are more likely to be seborrhoeic dermatitis,atopic dermatitis,psoriasis,tinea capitis,discoid lupus erythematosus and very rarely T cell lymphoma .The last 3 conditions listed will have associated hair loss or breakage.

Management- Take a scraping if you suspect a fungus and a skin biopsy if you cannot exclude discoid lupus especially if there is a recurrence of the rash around previously frozen areas on the face. 

 

SIGN DIP MEN     Overview of Red scaly diseases

 

S-Squamous      Psoriasis,Atopic eczema,Contact eczema,Seborrhoeic eczema,Pityriasis rosea,Pityriasis lichenoides,Pityriasis versicolor,Pityriasis rubra pilaris,Darier’s disease,Lichen planus,Erythrokeratoderma,Exfoliative dermatitis,Congenital ichthyosiform erythroderma,Lamellar ichthyosis,Epidermolytic hyperkeratosis,

 

I-Infective     Tinea corporis,Secondary syphilis,Tuberculosis,Leprosy,Leishmaniasis,Candidiasis

 

G-Granulomatous  Sarcoidosis 

 

N-Neoplastic    Superficial bcc and scc,Parapsoriasis,Mycosis fungoides,Sezary syndrome,Disseminated actinic porokeratoses,

 

D-Drugs  Exfoliative dermatitis eg gold,

 

I-Immunological   Discoid lupus erythematosus,Pemphigus foliaceous,Chronic actinic dermatitis

 

P-Physical     Sunburn,Scabies,Perforating disorders,

 

M-Metabolic  Glucagonoma syndrome,

 

E-Endocrine   

 

N-Nutritional      Pellagra, Acrodermatitis enteropathica,Kwashiokor,

 

Others   Ilven,