Clinics in Dermatology (2014) 32, 709–710
Commentary
Red face revisited: II In Red Face Revisited: I in Clinics in Dermatology,1 we focused on the major disorders that may affect the facial region. A red face, needless to say, can be caused by different disorders and underlying diseases. Red Face Revisited: II will continue to explore disorders related to infections, photoaging, psychologic factors, genodermatoses, and nasal septal and palatal ulcerations. The issue will also focus on facial cosmetics. The readers may ask, is it necessary to talk so much about the red face? Simply, yes. It is because it is embarrassing to have a red face. Having a red face may cause psychologic problems that need to be treated. This issue will continue by addressing additional causes of the red face and emphasize that a red face is not always rosacea. When should a patient seek medical care for a red face? How can the redness be controlled? Answers to these questions are to be found both in this issue and the previous one.
Bacterial, viral, and fungal infections Bacterial, viral, and fungal infections affecting the face may cause significant morbidity, cosmetic disfigurement, and psychologic distress. The chapters on the bacterial, viral, and fungal infections provide practical data to evaluate the clinical characteristics of these infections on the face.2,3,4
Demodicidosis Demodex mites are normal inhabitants of human hair follicles. In the “Demodicidosis” chapter, the authors describe the 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 in certain parts of the world. In the “Rarely seen infections” chapter, the authors give information on leishmaniasis and atypical mycobacterial infections, primarily.6 http://dx.doi.org/10.1016/j.clindermatol.2014.09.001 0738-081X/© 2014 Elsevier Inc. All rights reserved.
Extrinsic photoaging Chronic actinic damage, known as extrinsic photoaging, may lead to skin carcinogenesis. The chapter, “Chronic actinic damage of facial skin,” provides information about changes in human skin, the treatment options, and sun protection.7
Psychologic factors and consequences Some common facial dermatoses are considered to be influenced or triggered by emotional factors. The role of stress, anxiety, and depression is important and cannot be neglected. In the chapters related to psychologic factors and its consequences, the role of these factors and the problematic impact of the stigmatizing effect of some common visible skin conditions of the face are discussed.8,9
Genodermatoses Facial involvement represents a characteristic feature of a wide range of genodermatoses. In this chaper, the author divide facial involvement in genodermatoses into five morphologic categories based on the most prominent feature: papules, scaling, and photosensitivity/findings associated with aging.10
Disorders of hair growth and the pilosebaceous unit There are some disorders of hair and pilosebaceous follicle that may turn the face red. In the “Disorders of hair growth and the pilosebaceous unit” chapter, the authors review the epidemiology, clinical presentation, pathogenesis, and therapy of lichen planopilaris with its variants, discoid lupus erythematosus, folliculitis decalvans, dissecting folliculitis, acne keloidalis nuchae, pseudofolliculitis barbae, tinea capitis, tinea barbae, folliculitis of diverse etiologies and inflammatory
710 follicular keratotic syndromes, ulerythema ophryogenes, atrophoderma vermiculatum, keratosis follicularis spinulosa decalvans, and folliculitis spinulosa decalvans.11
Commentary different meanings. The authors state that a morphologic classification is a useful starting point instead of the conventional etiologic classification especially in dermatologic disorders.17
Flushing disorders In the chapter “The red face: flushing disorders,” the authors state that the term "red face" is reserved for lesions located exclusively or predominantly on the face, which result from changes in cutaneous blood flow triggered by multiple different conditions. The mechanisms of flushing, its clinical differential diagnosis, and management of various conditions that produce flushing are discussed.12
Facial cosmetics The chapters related to the cosmetics are presented, as they attract attention of the practicing dermatologists. Facial skin care products and cosmetics can both aid or incite facial dermatoses. There is also additional discussion on the use of makeup, 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 of numerous underlying infective, autoimmune, or systemic disorders; many of them may be idiopathic in nature. Historically, for nasal septal ulcerations, syphilis, leprosy, lupus vulgaris, DLE, and SCC have been described as common causes in dermatologic practice. The palatal ulceration can either be limited to the palate or represent a part of the generalized pathologic process involving the entire oral mucosa. The authors discuss the etiology, pathogenesis, classification, diagnosis, and management of ulcers.15,16
Follicular disorders The classification of “Follicular morphologic facial disorders” has rarely been done, because the term “follicular” has been used both clinically and histologically and can have
Yalçın Tüzün, MD Department of Dermatology, Cerrahpaşa Medical Faculty Istanbul University, 34098, Fatih, Istanbul, Turkey Corresponding author E-mail address: [email protected] Ronni Wolf, MD The Dermatology Unit, Kaplan Medical Center 76100 Rechovot, Israel Affiliated to the Hebrew University-Hadassah Medical School, Jerusalem, Israel E-mail address: [email protected]
References 1. Tüzün Y, Wolf R. Red Face Revisited: I. Clin Dermatol. 2014;32:1-158. 2. Laureano AC, Schwartz RA, Cohen PJ. Facial bacterial infections: 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: 839-872.
Commentary
Red face revisited: II In Red Face Revisited: I in Clinics in Dermatology,1 we focused on the major disorders that may affect the facial region. A red face, needless to say, can be caused by different disorders and underlying diseases. Red Face Revisited: II will continue to explore disorders related to infections, photoaging, psychologic factors, genodermatoses, and nasal septal and palatal ulcerations. The issue will also focus on facial cosmetics. The readers may ask, is it necessary to talk so much about the red face? Simply, yes. It is because it is embarrassing to have a red face. Having a red face may cause psychologic problems that need to be treated. This issue will continue by addressing additional causes of the red face and emphasize that a red face is not always rosacea. When should a patient seek medical care for a red face? How can the redness be controlled? Answers to these questions are to be found both in this issue and the previous one.
Bacterial, viral, and fungal infections Bacterial, viral, and fungal infections affecting the face may cause significant morbidity, cosmetic disfigurement, and psychologic distress. The chapters on the bacterial, viral, and fungal infections provide practical data to evaluate the clinical characteristics of these infections on the face.2,3,4
Demodicidosis Demodex mites are normal inhabitants of human hair follicles. In the “Demodicidosis” chapter, the authors describe the 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 in certain parts of the world. In the “Rarely seen infections” chapter, the authors give information on leishmaniasis and atypical mycobacterial infections, primarily.6 http://dx.doi.org/10.1016/j.clindermatol.2014.09.001 0738-081X/© 2014 Elsevier Inc. All rights reserved.
Extrinsic photoaging Chronic actinic damage, known as extrinsic photoaging, may lead to skin carcinogenesis. The chapter, “Chronic actinic damage of facial skin,” provides information about changes in human skin, the treatment options, and sun protection.7
Psychologic factors and consequences Some common facial dermatoses are considered to be influenced or triggered by emotional factors. The role of stress, anxiety, and depression is important and cannot be neglected. In the chapters related to psychologic factors and its consequences, the role of these factors and the problematic impact of the stigmatizing effect of some common visible skin conditions of the face are discussed.8,9
Genodermatoses Facial involvement represents a characteristic feature of a wide range of genodermatoses. In this chaper, the author divide facial involvement in genodermatoses into five morphologic categories based on the most prominent feature: papules, scaling, and photosensitivity/findings associated with aging.10
Disorders of hair growth and the pilosebaceous unit There are some disorders of hair and pilosebaceous follicle that may turn the face red. In the “Disorders of hair growth and the pilosebaceous unit” chapter, the authors review the epidemiology, clinical presentation, pathogenesis, and therapy of lichen planopilaris with its variants, discoid lupus erythematosus, folliculitis decalvans, dissecting folliculitis, acne keloidalis nuchae, pseudofolliculitis barbae, tinea capitis, tinea barbae, folliculitis of diverse etiologies and inflammatory
710 follicular keratotic syndromes, ulerythema ophryogenes, atrophoderma vermiculatum, keratosis follicularis spinulosa decalvans, and folliculitis spinulosa decalvans.11
Commentary different meanings. The authors state that a morphologic classification is a useful starting point instead of the conventional etiologic classification especially in dermatologic disorders.17
Flushing disorders In the chapter “The red face: flushing disorders,” the authors state that the term "red face" is reserved for lesions located exclusively or predominantly on the face, which result from changes in cutaneous blood flow triggered by multiple different conditions. The mechanisms of flushing, its clinical differential diagnosis, and management of various conditions that produce flushing are discussed.12
Facial cosmetics The chapters related to the cosmetics are presented, as they attract attention of the practicing dermatologists. Facial skin care products and cosmetics can both aid or incite facial dermatoses. There is also additional discussion on the use of makeup, 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 of numerous underlying infective, autoimmune, or systemic disorders; many of them may be idiopathic in nature. Historically, for nasal septal ulcerations, syphilis, leprosy, lupus vulgaris, DLE, and SCC have been described as common causes in dermatologic practice. The palatal ulceration can either be limited to the palate or represent a part of the generalized pathologic process involving the entire oral mucosa. The authors discuss the etiology, pathogenesis, classification, diagnosis, and management of ulcers.15,16
Follicular disorders The classification of “Follicular morphologic facial disorders” has rarely been done, because the term “follicular” has been used both clinically and histologically and can have
Yalçın Tüzün, MD Department of Dermatology, Cerrahpaşa Medical Faculty Istanbul University, 34098, Fatih, Istanbul, Turkey Corresponding author E-mail address: [email protected] Ronni Wolf, MD The Dermatology Unit, Kaplan Medical Center 76100 Rechovot, Israel Affiliated to the Hebrew University-Hadassah Medical School, Jerusalem, Israel E-mail address: [email protected]
References 1. Tüzün Y, Wolf R. Red Face Revisited: I. Clin Dermatol. 2014;32:1-158. 2. Laureano AC, Schwartz RA, Cohen PJ. Facial bacterial infections: 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: 839-872.
