Facial rash

Hi, does anyone have a guess as to what this might be?

I've had a tingling sensation in my face and lips for about 3 months. I've got chronically chapped lips and a rash over my cheeks and nose. The rash tends to flare up when I'm embarrassed or exposed to cigarette smoke and sometimes if I'm too warm. I also have a persistent cough. Can any allergy cause this? I've been to two doctors, one claimed I have rosacea, but I understand that this does not affect the lips. The other thought I had eczema but the rash isn't flaky at all. Anyone have any ideas? The doctors don't seem too bothered.

[Bhupinder Kaur, MD]

Hello,
For the cheeks rash, rosacea is the first possibility. Other possibility is of eczema skin. For chapped lips also, eczema needs to be ruled out. Cheilitis(Inflammation of the skin on and around the lips)is often seen in atopic dermatitis and eczema. Diagnosed by blood test like RAST. Treatment is by topical steroids or oral therapy of corticosteroids in severe cases.

It is very difficult to precisely confirm a diagnosis without examination and investigations and the answer is based on the medical information provided. For exact diagnosis, you are requested to consult your doctor. I sincerely hope that helps. Take care and please do keep me posted on how you are doing.