Laurent Misery


Expert Rev Dermatol. 2013;8(6):631-637. 

In This Article

Differential Diagnosis

In the case of erythema, a diagnosis of sensitive skin could be considered for a high number of skin diseases. However, the association with abnormal sensations, which are pricklings and stinging rather than pruritus; the triggering factors; and the transitory nature of the erythema are strong arguments for a diagnosis of sensitive skin. The main differential diagnosis aid that remains are the flushes that are observed in patients who are suffering from rosacea.[34] Differences are still debated but we propose a summary in Table 1.

In the absence of erythema, the diagnosis of sensitive skin is easy. Nonetheless, it is necessary to keep in mind that abnormal sensations without any objective symptoms could also be related to small-fiber neuropathies,[52] large-fiber neuropathies or neuropathies due to spinal compression,[53] as summarized in Table 2. In In contrast to sensitive skin, the anatomical distribution of symptoms is related to innervation. Other differential diagnoses are somatoform skin diseases.[54]

In the specific case of a sensitive scalp, the diagnosis must be based on neuropathies,[53] other causes of an itchy scalp[49,50] and trichodynia.[55] Trichodynia is a painful sensation at the scalp that is localized in the area of hair loss (androgenetic alopecia, telogen effluvium or alopecia areata).