Face Red Papules and Plaques

Red Facial Papules and Plaques

Red non scaly papules or plaques suggest an infiltrate or tumour. The main infiltrates would be neutrophils in Sweet's syndrome,  lymphocytes in lymphocytoma or T cell lymphoma or Lymphomatoid papulosis, Eosinophilis in eosinophilic folliculitis

 Infiltrates of substances include mucin in papular or follicular mucinosis, calcium in miliary calcinosis and infiltatrates of organisms in leishmaniasis or spirochaetes in syphilis. or acid fast bacilli in Leprosy.

Tumours can also present as red non scaly papules particularly Trichoepitheliomas, Trichilemmomas and Perifollicular fibromas.

Rosacea presents with red non scaly papules as does sarcoidosis but the accompanying flushing and pustules makes rosacea easy to diagnose.

Lupus usually gives plaques rather than papules but Tumid lupus may present as papules as can bite reactions or PMLE. Granuloma faciale usually presents with a plaque rather than as papules.

Most of these conditions are covered in the Red Non Scaly Mnemonic of CUL DVA EVIE

Generally a punch biopsy will be taken of a papule or plaque except in Rosacea where more often the diagnosis is made clinically. 

Lets look at the Clinical and Histology of these conditions

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