A new facial rash

A male mechanic, aged 67 years, presents with a new-onset facial rash of six months' duration. The rash started around the preauricular region and spread to involve bilateral cheeks and forehead. He now has an erythematous papular rash over the malar region and the forehead with coarse white scales (Figure 1). The perioral region and nasolabial folds are spared, suggesting photosensitivity. The patient mentions mild itchiness associated with the rash.