Thursday, October 15, 2009

Idiopathic erythema

My friends used to worry that my father, a psychiatrist, was secretly diagnosing their psychopathology when they'd stop by the house. On average, one word--adolescence--was all that was needed to label our deviance from normal behavior during those formative years.

Sometimes, I like to play 'guess the diagnosis' when I'm out and about in public. During PTA meetings at my daughter's high school, I'd sit and wonder why another parent's face was so red (the meeting content, as you may guess, was simply riveting!). I never did figure it out, nor do I have the slightest idea what happened to the man in the years since last we met. I was disturbed, however, to come across an item in a medical journal that suggested that his diagnosis may not have been benign.

Idiopathic erythema is a fancy way of saying the skin is red and we don't know why. One of my fellow residents during training had allergic dermatitis (eczema) as a cause of his not-so-idiopathic erythema. Those patients who are red for unknown reasons tend to be male (73%) and older (average age 69 years in one study).

Out of 218 Singaporeans studied by dermatologists there, 18% were ultimately found to have cancer. Dr. Steven Thng and his colleagues concluded, "We recommend close follow-up with reevaluation for malignancy even if the intitial investigation had been negative."

I hope this fellow is doing well, ruddy but cancer-free. But I now have something new to think about when a patient complains "Boy is my face red!"


Anonymous said...

An old boyfriend had a "ruddy" complexion but I won't be passing this along after the inglorious dumping he inflicted on me -- thirty years ago, but still...
Also, I suspect the dad at the mind numbing PTA meeting had a cocktail or two to make it through the meeting. In that case, not idiopathic!

femail doc said...

Anon: I definitely considered that possibility for his unnatural glow. I too have been red-faced at a meeting, not alcohol-induced but as a result of unvoiced fury.

kenju said...

I assume this is something different from rosacea.

We just spent the weekend with a man who has a very red face in spots - mainly on the sides of the cheeks near the ears, with many tiny capillaries showing. I wondered what would cause that. Is that what you are referencing?

Anonymous said...

Voice your fury and let everyone else's faces go red!