A 40-year-old woman presents with inflammatory papules on her face. What is the most likely diagnosis?

In this case, the presence of inflammatory papules on the face in a 40-year-old woman suggests a diagnosis of Rosacea. Rosacea is characterized by persistent facial redness, flushing, and the development of inflammatory papules and pustules, particularly on the central face.

The age of the patient also supports this diagnosis, as Rosacea commonly manifests in adults, often between the ages of 30 and 50. Additionally, the inflammatory papules associated with Rosacea can sometimes be mistaken for acne; however, Rosacea typically does not involve comedones (blackheads), which are characteristic of acne vulgaris.

In contrast, Hot tub folliculitis generally presents with pruritic, papular lesions that arise in areas exposed to contaminated hot water, and it is more common after using a hot tub. Acne vulgaris is often associated with the presence of comedones, which are absent in Rosacea, and is typically more common among adolescents or young adults. Perioral dermatitis commonly presents as small papules and pustules around the mouth, and while it can occur in women in their 30s and 40s, the distinctive presentation helps differentiate it from Rosacea.

Therefore, the overall clinical picture aligns most closely with