Differential Diagnosis for Neonatal Facial Rash
- Single most likely diagnosis
- Atopic Dermatitis (Eczema): The presence of erythematous, scaly, and papular lesions distributed symmetrically over the face, along with dry skin and fine scaling, is consistent with atopic dermatitis. The fact that the patient seems unbothered and has no signs of infection also supports this diagnosis.
- Other Likely diagnoses
- Seborrhoeic Dermatitis: This condition is common in infants and can present with a similar rash on the face, including the forehead, eyelids, and cheeks. It often appears as a greasy, yellowish scale.
- Acne Neonatorum: Although less common, neonatal acne can occur due to exposure to maternal hormones and can present with papular lesions on the face.
- Irritant Contact Dermatitis: Given the patient's age and the fact that the rash is limited to the face, irritant contact dermatitis due to exposure to soaps, lotions, or other products is a possibility.
- Do Not Miss (ddxs that may not be likely, but would be deadly if missed)
- Congenital Infections (e.g., Congenital Syphilis, Congenital Rubella): Although the patient's presentation does not strongly suggest an infectious etiology, congenital infections can have varied presentations, including skin rashes. Missing these diagnoses could have severe consequences.
- Staphylococcal Scalded Skin Syndrome (SSSS): This condition, caused by staphylococcal toxins, can present with erythematous skin and scaling, but typically involves more widespread areas and can be life-threatening if not recognized and treated promptly.
- Rare diagnoses
- Langerhans Cell Histiocytosis: A rare condition that can present with skin lesions, including those on the face, but is often accompanied by other systemic symptoms.
- Incontinentia Pigmenti: A genetic disorder that can cause skin lesions, including those on the face, but typically has other characteristic features such as blistering and hyperpigmentation.