A recurrent, unsightly facial eruption in a stressed but well young adult

A 29-year-old man attends your clinic with a 4-year history of a recurrent and itchy
facial eruption that he feels is unsightly. He notices the eruption is worse in the winter
and tends to improve over the summer. He is currently studying for business exams and
feels the associated stress has triggered the current flare. He avoids soaps, which make his
face sore, and recently has reduced his alcohol intake in an effort to improve his eruption.
He is otherwise well and on no medication.
A full examination is unremarkable except for the skin of his face, neck, central chest and
scalp. There are poorly defined erythematous patches with overlying adherent greasy scale
affecting his naso-labial folds and extending onto his cheeks (Fig. 4.1). His eyebrows,
scalp, nape of his neck and central chest are similarly affected.

• What is this eruption?
• What age groups are affected?
• How would you manage this patient?IAL ERUPTION IN A STRESSED BUT WELL YOUNG ADULT