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Date of last update: 10/18/2017.

Forum Name: Dermatology Topics

Question: Chronic and Persistent Facial Redness

 85Bears - Wed Mar 25, 2009 10:15 pm

Age: 24
Sex: Male

AUG 2008: Weight-lifting. Experienced excessive straining; onset of bright redness in cheeks immediately thereafter. Subsided partially yet remained.

AUG 2008-DEC 2008: Experienced intense emotional anxiety. Onset of acute acne vulgaris in affected regions with increase in generalized redness; development of papules within affected regions.

DEC 2008-MAR 2009: Intermittent acne vulgaris with consistent redness; two pea-sized, cyst-like developments under skin which subsided over time but left small nodules in their place; no more have developed. Sought medical treatment from a D.O., diagnosed (incorrectly, I believe) as a simple case of acne vulgaris, prescribed topical antibiotics. Acne vulgaris has since subsided but redness remains, along with superficial red marks where pimples or papules had previously developed; superficial red marks do not appear to subside over time. Some papules remain persistent; one has been on my face for over two months whereas the other has remained for over a month. They are small, red bumps that do not crust or contain pus.

HISTORY: No history of acne or redness prior to onset; neither parents suffer from acne or rosacea. Believe acne vulgaris to be result of extreme anxiety (which has partially diminished) and poor facial hygiene (excessive scrubbing and application of acne ointments), which has been rectified.

PERSONAL: Redness, papules, and superficial red spots have caused mild depression. Interfering with social life and school work.

OTHER: Conducted research. Found a possible diagnosis at Dermatology Online Journal. Symptoms and appearance of "solid facial edema" in patient match mine during most acute phases (AUG 2008-DEC 2008), although current appearance is noticeably better than the case referenced.

Link: ... patel.html

Any help would be greatly appreciated.
 John Kenyon, CNA - Thu Mar 26, 2009 10:46 pm

User avatar Hello --

Either solid facial edema or, more likely, rosacea, could be responsible for this episode. Solid facial edema is usually a complication of common acne vulgaris, and it seems there's no history of this in you or either parent. Not impossible, but less likely. Rosacea can appear without family history as well, and it would probably be useful to treat with steroids, since both conditions do respond to this. If you have a history of past acute anxiety this could of course contribute to the flareup, but wouldn't be the sole cause. With treatment there should also be a search for underlying causes, such as an ANA titer to see if there is possibly a lean toward scleroderma or other autoimmune disease which could manifest this way as well.

Hope this is helpful to you. Good luck with this and please follow up with us as needed.

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