Last reviewed: October 2023
Author: Dr Francisco Flores; Dr Brittany Tsai; and Dr Maryam Ameen, Dermatologists, Ross University School of Medicine, New Jersey, USA (2023)
Reviewing dermatologist: Dr Ian Coulson (2023).
Edited by the DermNet content department
The patient is a 13-year-old male who presents with redness on both cheeks for 13 months. The facial flush is more pronounced with psychological stress. Physical examination shows bilateral pink erythematous base with raised scaly 'spike-like' lesions on the cheeks.
The diagnosis is keratosis pilaris rubra. This condition is a variant of keratosis pilaris, and there are often typical lesions of keratosis pilaris on the upper arms and thighs. There may also be discernible pigmentation as well as redness on the cheeks, and it may extend onto the neck (often referred to as erythromelanosis faciei et coli).
It is easier to discern in pale skin individuals. It is often associated with atopic eczema and ichthyosis vulgaris.
Emollients containing urea, lactic acid or salicylic acid, or topical retinoids may diminish the scale.
Definitive treatments to reduce the redness include pulsed dye laser to help with erythema or laser-assisted hair removal for ingrown hairs.
Differential diagnoses include:
For more information, see Keratosis pilaris.
