creation date: 2026-08-02 17:01
tags: Assessments
Pediatric Dermatology Lesions & Exanthems
Background
Several dermatologic conditions are more common in pediatric populations. Some conditions overlap with dermatology lesions page.
Conditions
Irritant Contact Dermatitis (Diaper Rash)
Clinical Findings
- Erythema
- Shiny, red macules/patches
- No skin fold involvement
- Scaling possible
Pathophysiology
Diagnosis/Treatment
- Eliminate contact (eg. no-diaper time, frequent changes)
- Topical barriers
- Short term topical corticosteroids
Candidal Dermatitis
Clinical Findings
- Erythematous macerated papules/plaques
- Satellite papules/pustules
- Skin fold involvement
- Rash lasts >3 days
Pathophysiology
- Secondary to C. albincans from fecal origin
Diagnosis/Treatment
- Antifungals
- No amoxicillin (will worsen)
Seborrheic Dermatitis (Cradle Cap)
Clinical Findings
- Greasy, yellowish-white scale with erythema
- Predilection for nasolabial folds, eyebrows, scalp, external ear canals, chest
- Chronic relapsing course
- Worsens with stress, fatigue, neurological disease
- Dandruff is a mild scalp form
Pathophysiology
- Malassezia yeast metabolizes sebum triglycerides (in sebum rich areas such as face and scalp)
- Free fatty acids from metabolized TGs disrupt skin barrier
- Disrupted skin barrier allows for inflammatory activation
Diagnosis/Treatment
- Ketoconazole shampoo/cream
Neonatal / Infantile Acne
Clinical Findings
- Papules/pustules on forehead, cheeks, and upper chest
- Starts age 2-3 weeks (neonatal) or after 3 months (infantile)
- Resolves spontaneously
Pathophysiology
Diagnosis/Treatment
- Resolves spontaneously, reassure
Milia
Clinical Findings
- 1-2 mm firm, white, pearly pinpoint papules
Pathophysiology
- Keratin retained in follicles causes papules
Diagnosis/Treatment
- Self-resolves within a few weeks of life
Miliaria
Clinical Findings
- Localized, pruritic vesicles
- Irritation, itching, rash types (depends on depth of trap)
Pathophysiology
- Plugged sweat gland ducts
Diagnosis/Treatment
Congenital Dermal Melanocytosis
Clinical Findings
- Slate grey patches on the lower trunk
- May look like bruises
- Presents between birth to 2-3 years of age
- More common in Asian/Black babies
Pathophysiology
Diagnosis/Treatment
Erythema Toxicum Neonatorum
Clinical Findings
- Erythematous macules and papules
- Becomes pustules
- Distributed trunk, proximal extremities; spares palms/soles
- Presents between 24 hours of life to 5-7 days
Pathophysiology
Diagnosis/Treatment
- Self resolving
Nevus Simplex (Salmon Patch)
Clinical Findings
- Macular, vascular malformataion of eyelid/neck
Pathophysiology
Diagnosis/Treatment
- Self resolves within 1 year
Measles
Varicella (Chickenpox)
Neonatal Varicella Syndrome
Rarely, infants with mothers that had varicella infection early in pregnancy can result in neonatal varicella syndrome causing a number of congenital abnormalities. May present as:
- Hemorrhagic exanthem 5-12 days postpartum
Roseola
Clinical Findings
- High fever that subsides suddenly
- Rose-pink macules and papules with white halos
Pathophysiology
Diagnosis/Treatment
Blueberry muffin
Clinical Findings
- Rare clinical sign for several conditions
- Widespread, maculopapular lesions of blue-red or violaceous colour and cohesive consistency
Pathophysiology
May be due to:
- Congenital rubella
- TORCH syndrome
- Hematologic dyscrasias
- Neoplasms