Ulerythema Differential Diagnoses

Updated: Jun 28, 2022
  • Author: Camila K Janniger, MD; Chief Editor: Dirk M Elston, MD  more...
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Diagnostic Considerations

Differentiate the following:

  • Atrophoderma vermiculatum [24]

  • Keratosis pilaris atrophicans (ulerythema ophryogenes) and keratosis pilaris decalvans

  • Psoriasis, atopic dermatitis, pityriasis rubra pilaris, and ichthyosis vulgaris

  • Erythromelanosis follicularis faciei [25, 26]

  • Folliculotropic mycosis fungoides [27]

  • Nilotinib-induced keratosis pilaris‒like eruption [28]

  • Zhu‐Tokita‐Takenouchi‐Kim (ZTTK) syndrome [29]

  • Frontal fibrosing alopecia [30]

Ulerythema is not always differentiated from keratosis pilaris, which is rather common in young women; keratosis pilaris commonly occurs on the extensor surfaces of the arms. Keratosis follicularis spinulosa decalvans mainly affects the scalp, but it should also be considered a differential diagnosis.

Pityriasis rubra pilaris and psoriasis may also require distinction. Although pityriasis rubra pilaris may be similar to psoriasis, important clinical symptoms of psoriasis are missing, including the whitish scales, the Auspitz sign, and the nail pitting. The tiny follicular yellow-red papules are a typical clinical sign of pityriasis rubra pilaris, thereby distinguishing it from psoriasis.

In small children, ulerythema must be differentiated from seborrhoic dermatitis and from atopic dermatitis.

Graham-Little syndrome, an unusual form of lichen planopilaris, characterized by the presence of cicatricial alopecia on the scalp, keratosis pilaris of the trunk and extremities, and noncicatricial hair loss of the pubis and axillae, sometimes requires distinction. [31]

Unilateral keratosis pilaris atrophicans faciei may mimic follicular mucinosis. [32]

Differential Diagnoses