Chapter 1: Introduction to Clinical Dermatology

Selected Differential Diagnosis

In dermatology, the differential diagnoses are most often organized by the morphology of the lesions seen on physical exam. Other variables considered include the distribution of lesions, relevant exposures, as well as the age and overall health of the patient. Below are common conditions encountered in pediatric dermatology for the select morphologies.

Scaly Papules or Plaques

  • Dermatitis

    • Atopic dermatitis
    • Nummular dermatitis
    • Contact dermatitis

  • Seborrheic dermatitis
  • Psoriasis
  • Tinea corposis
  • Pityriasis rosea
  • Pityriasis lichenoides

Hyperpigmentated

  • Post-inflammatory hyperpigmentation
  • Café-au-lait macules
  • Dermal melanocytosis
  • Acanthosis nigricans
  • Nevi: acquired and congenital
  • Retention hyperkeratosis
  • Lentigo

Hypopigmented or Depigmented

  • Pityriasis versicolor
  • Pityriasis alba
  • Vitiligo
  • Post-inflammatory hypopigmentation
  • Nevus depigmentosis
  • Nevus anemicus

Solitary Papules

  • Molluscum contagiosum
  • Dermatofibroma
  • Verruca vulgaris (wart)
  • Skin tags
  • Arthropod bites
  • Pilomatricoma
  • Prurigo nodules
  • Scabetic nodules
  • Juvenile xanthogranuloma

Vascular Appearing Papules and Plaques

  • Infantile hemangioma
  • Congenital hemangioma
  • Pyogenic granuloma
  • Spider angiomas
  • Spitz nevus
  • Amelanotic melanoma

Vesicles and Bullae

  • Viral infection

    • VZV
    • HSV
    • Hand foot and mouth

  • Bullous impetigo
  • Acute contact dermatitis
  • Drug reactions - SJS/TEN
  • Erythema multiforme
  • Epidermolysis bullosa
  • Incontinentia pigmenti
Morbilliform Eruption

  • Morbilliform drug eruption
  • Viral exanthem
  • Kawasaki disease
  • DRESS or early SJS/TEN
  • Connective tissue disease

Pustules

  • Acne vulgaris
  • Folliculitis
  • Furuncles
  • AGEP (Drug reaction)
  • Impetigo
  • Candidiasis
  • Hidradenitis Suppurativa
  • Scabies
  • Pustular psoriasis

Diffuse Erythema

  • Viral exanthems
  • Drug reactions
  • Sunburn
  • Atopic dermatitis
  • Psoriasis
  • Pityriasis rubra pilaris

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Pediatric Dermatology Copyright © 2023 by Dr. Wingfield E. Rehmus, MD, MPH; Dr. Jamie Phillips; Dr. Lisa Flegel; Dr. Saud Alobaida; and Hannah Podoaba is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License, except where otherwise noted.

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