1. Papulosquamous skin disease marked by a history of waxing and waning in severity and scaling in perinasal area manifested in this patient.
Diagnosis: Seborrheic dermatitis presenting as erythema with scaling on the perinasal and perioral area. Similar to rosacea, seborrheic dermatitis is a chronic and relapsing erythematous rash with well-demarcated erythematous patches, papules, or plaques; however, unlike rosacea, the distribution varies from minimal asymptomatic scaliness of the scalp to more widespread involvement (eg, scalp, ears, upper aspect of the trunk, intertriginous areas). Also, although macular erythema and scaling involving the perinasal area may be seen in either rosacea or seborrheic dermatitis, a greasy quality to the scales and involvement of other sites such as the scalp, retroauricular skin, and eyebrows suggest a diagnosis of seborrheic dermatitis
Read more about seborrheic dermatitis at The great mimickers of rosacea. Cutis. 2014;94(1):39-45.