The red face-an overview and delineation of the MARSH syndrome.

The problem of the red face in females is reviewed. After excluding common causes such as contact dermatitis, seborrhoeic eczema and photodermatitis the diseases affecting the remaining patients fall into three groups: marked erythema with no feeling of heat or sensitivity, usually erythromelanosis faciei; marked flushing and burning with intense sensitivity for which the term facial erythrodysaesthesia is proposed; the so-called MARSH syndrome in which an overlap of androgen-dominant symptoms occurs - melasma, acne, rosacea, seborrhoeic eczema, and hirsutism. The latter group may respond best to low dose oral isotretinoin.