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Acute lupus erythematosis

The malar rash of lupus is typically bilateral, not as warm or tender as erysipelas, and is associated with systemic autoimmune features.

Dermatomyositis

The violaceous rash of dermatomyositis is not acutely tender, warm, or as sharply demarcated as erysipelas, and is associated with muscle weakness.

Drug phototoxicity

This is a sunburn-like reaction in sun-exposed areas related to a drug, not a sharply defined, advancing plaque of infection.

Eczema

Acute eczematous dermatitis is intensely itchy and often vesicular, whereas erysipelas is more painful and presents as a solid plaque of erythema.

Fifth disease

The "slapped cheek" appearance of this viral illness is a brighter red, less indurated, and not tender or warm like the bacterial infection of erysipelas.

Psoriasis

A psoriatic plaque is distinguished by its thick, silvery scale and is a chronic lesion, not an acute, tender, febrile illness like erysipelas.

Rosacea

While causing facial redness, rosacea is characterized by papules, pustules, and flushing, and lacks the abrupt onset, high fever, and well-demarcated, raised border of erysipelas.

Subacute lupus erythematosis

SCLE presents with annular or papulosquamous plaques, a different morphology than the confluent, edematous plaque of erysipelas.

Sunburn

A sunburn is a painful erythema corresponding to UV exposure and lacks the sharp, raised, advancing border that is the hallmark of erysipelas.

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