A 22-year-old Hispanic woman presented to the office asking for evaluation of a rash on her face. The patient complained that the rash appeared on her nose and cheeks after brief sun exposure and lasted for nearly a week. She stated that this has occurred on multiple occasions within this past year. Physical exam revealed a superficial erythematous plaque on the nasal bridge and cheekbones. The patient admitted that she was not diligent about applying sunscreen on her face in the past. She is not on any medications, and her family history is remarkable for rheumatoid arthritis in her mother and lupus in her maternal grandmother.

Dermatomyositis is an inflammatory disease of the skin and skeletal muscles. Although the muscular inflammation can occur after the cutaneous manifestations in this disease, the patient did not present with the characteristic skin involvement of the hands and knuckles of dermatomyositis, making this diagnosis less likely. Rosacea often occurs after the age of 30 and often appears with papules and pustules. Although this patient’s lesion was located in an area common for rosacea, the diagnosis is less likely. Finally, seborrheic dermatitis can present as a red lesion over the malar region of the face; however, it may also present with dry, yellow scale at the inflamed base which this patient did not have.