Clinics in Dermatology (2014) 32, 709–710

Commentary

Red face revisited: II

In Red Face Revisited: I in Clinics in Dermatology,1 wefocused on the major disorders that may affect the facial region.

Extrinsic photoaging

A red face, needless to say, can be caused by different disordersand underlying diseases.Red Face Revisited: IIwill continue toexplore disorders related to infections, photoaging, psychologicfactors, genodermatoses, and nasal septal and palatal ulcera-tions. The issue will also focus on facial cosmetics.

The readersmay ask, is it necessary to talk somuch about thered face? Simply, yes. It is because it is embarrassing to have ared face. Having a red face may cause psychologic problemsthat need to be treated. This issue will continue by addressingadditional causes of the red face and emphasize that a red face isnot always rosacea.When should a patient seekmedical care fora red face?How can the redness be controlled?Answers to thesequestions are to be found both in this issue and the previous one.

Bacterial, viral, and fungal infections

Bacterial, viral, and fungal infections affecting the facemaycause significant morbidity, cosmetic disfigurement, andpsychologic distress. The chapters on the bacterial, viral, andfungal infections provide practical data to evaluate the clinicalcharacteristics of these infections on the face.2,3,4

Demodicidosis

Demodex mites are normal inhabitants of human hairfollicles. In the “Demodicidosis” chapter, the authors describethe role of Demodex mites in acneiform eruptions, folliculitis,and a range of eruptions in immunosuppressed patients.5

Rarely seen infections

Rare cutaneous infections of the face are reported incertain parts of the world. In the “Rarely seen infections”chapter, the authors give information on leishmaniasis andatypical mycobacterial infections, primarily.6

http://dx.doi.org/10.1016/j.clindermatol.2014.09.0010738-081X/© 2014 Elsevier Inc. All rights reserved.

Chronic actinic damage, known as extrinsic photoaging,may lead to skin carcinogenesis. The chapter, “Chronicactinic damage of facial skin,” provides information aboutchanges in human skin, the treatment options, andsun protection.7

Psychologic factors and consequences

Some common facial dermatoses are considered to beinfluenced or triggered by emotional factors. The role ofstress, anxiety, and depression is important and cannot beneglected. In the chapters related to psychologic factors andits consequences, the role of these factors and theproblematic impact of the stigmatizing effect of somecommon visible skin conditions of the face are discussed.8,9

Genodermatoses

Facial involvement represents a characteristic feature of awide range of genodermatoses. In this chaper, the authordivide facial involvement in genodermatoses into fivemorphologic categories based on the most prominent feature:papules, scaling, and photosensitivity/findings associatedwith aging.10

Disorders of hair growth and the pilosebaceous unit

There are some disorders of hair and pilosebaceous folliclethat may turn the face red. In the “Disorders of hair growth andthe pilosebaceous unit” chapter, the authors review theepidemiology, clinical presentation, pathogenesis, and therapyof lichen planopilaris with its variants, discoid lupuserythematosus, folliculitis decalvans, dissecting folliculitis,acne keloidalis nuchae, pseudofolliculitis barbae, tinea capitis,tinea barbae, folliculitis of diverse etiologies and inflammatory

710 Commentary

follicular keratotic syndromes, ulerythema ophryogenes,atrophoderma vermiculatum, keratosis follicularis spinulosadecalvans, and folliculitis spinulosa decalvans.11

Flushing disorders

In the chapter “The red face: flushing disorders,” theauthors state that the term "red face" is reserved for lesionslocated exclusively or predominantly on the face, whichresult from changes in cutaneous blood flow triggered bymultiple different conditions. The mechanisms of flushing,its clinical differential diagnosis, and management of variousconditions that produce flushing are discussed.12

Facial cosmetics

The chapters related to the cosmetics are presented, asthey attract attention of the practicing dermatologists. Facialskin care products and cosmetics can both aid or incite facialdermatoses. There is also additional discussion on the use ofmakeup, an integral part of our society’s sense of beauty,fashion, and social well being.13,14

Nasal septal ulceration and palatal ulceration

Nasal septal ulceration and palatal ulceration are defined,by definition, as tissue loss. They may be the first signs ofnumerous underlying infective, autoimmune, or systemicdisorders; many of them may be idiopathic in nature.Historically, for nasal septal ulcerations, syphilis, leprosy,lupus vulgaris, DLE, and SCC have been described ascommon causes in dermatologic practice. The palatalulceration can either be limited to the palate or represent apart of the generalized pathologic process involving theentire oral mucosa. The authors discuss the etiology,pathogenesis, classification, diagnosis, and management ofulcers.15,16

Follicular disorders

The classification of “Follicular morphologic facialdisorders” has rarely been done, because the term “follicular”has been used both clinically and histologically and can have

different meanings. The authors state that a morphologicclassification is a useful starting point instead of theconventional etiologic classification especially in dermato-logic disorders.17

Yalçın Tüzün, MDDepartment of Dermatology, Cerrahpaşa Medical Faculty

Istanbul University, 34098, Fatih, Istanbul, TurkeyCorresponding author

E-mail address: yalcintuzun@gmail.com

Ronni Wolf, MDThe Dermatology Unit, Kaplan Medical Center

76100 Rechovot, IsraelAffiliated to the Hebrew University-Hadassah Medical

School, Jerusalem, IsraelE-mail address: wolf_r@netvision.net.il

References

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Folliculitis. Clin Dermatol. 2014;32:711-714.3. Avci O, Ertam I. Viral infections of the face. Clin Dermatol. 2014;32:

715-733.4. Elston CA, Elston DM. Red face and fungi infection. Clin Dermatol.

2014;32:734-738.5. Welsh O, Vera-Cabrera L. Dermodex mites. Clin Dermatol. 2014;32:

739-743.6. Amer M, Amer A. Rarely seen infections. Clin Dermatol. 2014;32:

744-751.7. Bilaç C, Şahin MT, Öztürkcan S. Chronic actinic damage of facial skin.

Clin Dermatol. 2014;32:752-762.8. Orion E, Wolf R. Psychologic factors in the development of facial

dermatoses. Clin Dermatol. 2014;32:763-766.9. Orion E, Wolf R. Psychologic consequences of facial dermatoses. Clin

Dermatol. 2014;32:767-771.10. Schaffer JV. Facial involvement in genodermatoses. Clin Dermatol.

2014;32:772-783.11. Ramos-e-Silva M, Pirmez R. Red face revisited: Disorders of hair

growth and the pilosebaceous unit. Clin Dermatol. 2014;32:784-799.12. İkizoğlu G. Red face revisited: Flushing. Clin Dermatol. 2014;32:800-808.13. Draelos ZD. Facial skin care products and cosmetics. Clin Dermatol.

2014;32:809-812.14. Filinte GT, Aköz T. Camouflage therapy in aesthetic surgery. Clin

Dermatol. 2014;32:813-816.15. Sardana K, Goel K. Nasal septal ulceration. Clin Dermatol. 2014;32:

817-826.16. Sardana K, Bansal S. Palatal ulceration. Clin Dermatol. 2014;32:827-838.17. Sardana K. Follicular disorders of the face. Clin Dermatol. 2014;32:

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