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The words I am thinking of in particular are 表情, 面持ち, 顔色, 顔つき, and 面相.

I understand that 表情 is the most common, 面持ち is only for negative expressions,
顔色 more often refers to complexion rather than facial expression, and 顔つき can
also refer to facial features in general. But beyond that, I don't understand
any of the nuances.

For example (coming from google searching): it seems 汚い表情, 汚い顔つき, and 汚い面相 are
all valid ways to refer to a "dirty look", but 面持ち can't be used and 汚い顔色
refers to skin complexion issues

In another example, 表情を読む, 顔色を読む, and even (rarely) 面相を読む are valid, but
面持ちを読む and 顔つきを読む are not.

Are these fixed idiomatic expressions? Or is there some pattern to the nuances
between them which makes it "obvious" when you can or cannot use them?
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question
word-choice nuances
What are the nuances for various words referring to "facial expression"?
It is mostly about collocations, and in terms of meaning they are generally
not too different.

First, you can forget **面相**. Except for expressions like 百面相 meaning _a
hundred disguises_ (so it means more "facial masks"), it is practically never
used in modern speech. 汚い面相 or 面相を読む is not idiomatic in this sense.

**面持ち** is, as you are aware, modified by some negative adjective (悲しそうな=sad-
looking, 陰鬱な=gloomy, etc.). Practically Xな面持ち means _with X atmosphere_ , so
you don't have to 'read' it (rather the face already reveals the person is X),
hence 面持ちを読む is not possible.

**顔つき** is something that is apparent physically or by looking from outside,
so again it won't be read. It tends to combine well with what is typically
judged by looks. For example, 上品な顔つき or 怒ったような顔つき means _elegant face_ /
_angry face_ , respectively. 上品な表情 is much less idiomatic (or impossible);
怒ったような表情 is okay.

**顔色** is usually good or bad - 顔色がよい/わるい. Adjectives like 汚い cannot be
applied. Also, it is literally a 'color' which is supposed to tell how the
person feels, so something that is to be read.

Finally, **表情** is mostly neutral; it is literally a facial expression -
laugh/grin/frown/etc, how parts of the face are changed temporarily. So, it
can be implicit like 顔色 and explicit like 顔つき.

* * *

BTW, actually none of the 汚い+N sounds very natural to me.
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answer