Peer Reviewed

What's Your Diagnosis?

How Would You Diagnose This Red Patch on an Older Man’s Face?

  • AUTHORS:
    Brandon Ng1 • Jenna O’Neill, MD2 • Joelle Maloney, PA2 • Thomas N. Helm, MD2

    AFFILIATIONS:
    1Albany Medical College, Albany, New York
    2The Buffalo Medical Group Department of Dermatology, Buffalo, New York

     

    ITATION:
    O’Neill J, Ng B, Maloney J. How would you diagnose this red patch on an older man’s face? Consultant. 2022;62(7):e14-e16. doi:10.25270/con.2021.10.00014

    Received May 6, 2021. Accepted June 8, 2021. Published online October 28, 2021.

    DISCLOSURES:
    The authors report no relevant financial relationships.

    CORRESPONDENCE:
    Brandon Ng, Albany Medical College, 47 New Scotland Avenue, Albany, NY 12208 (ngb@amc.edu)


     

    An 87-year-old man presented to our clinic for evaluation of progressive redness limited to the right cheek that had worsened over the past few months (Figure 1). He denied pain or itching. The red patch was treated with minocycline, 100 mg twice daily for 10 days for presumed rosacea. However, treatment did not improve the patient’s symptoms.

    Figure 1. The patient presented with a red patch on his right cheek.
    Figure 1.
    The patient presented with a red patch on his right cheek.

     

    His medical history was unremarkable except for essential hypertension and hypercholesterolemia. A physical examination revealed erythema and induration but no scaling or pustules. A biopsy was also conducted (Figure 2).

    Figure 2. A CD34 stain showed irregular vascular channels in the dermis (400× magnification).
    Figure 2.
    A CD34 stain showed irregular vascular channels in the dermis (400× magnification).

     

     

    (Answer and discussion on next page.)