Differential Diagnosis for a 15-year-old Female with a Neck Rash
Single most likely diagnosis
- Contact dermatitis: This is a common condition in adolescents, often caused by irritants or allergens such as jewelry, fragrances, or dyes in clothing. The rash typically appears as red, itchy, and inflamed skin.
Other Likely diagnoses
- Eczema (atopic dermatitis): A chronic skin condition characterized by dry, itchy, and inflamed skin. It often affects the neck, face, and extremities.
- Impetigo: A highly contagious bacterial skin infection that can cause red sores or blisters on the skin, often on the face, neck, or hands.
- Tinea corporis (ringworm): A fungal infection that can cause a ring-shaped rash on the skin, often itchy and red.
- Insect bite reaction: Allergic reactions to insect bites can cause red, itchy, and swollen skin lesions.
Do Not Miss (ddxs that may not be likely, but would be deadly if missed)
- Meningitis: Although rare, a rash on the neck can be a sign of meningitis, especially if accompanied by fever, headache, and stiff neck.
- Lymphoma: Certain types of lymphoma, such as Hodgkin lymphoma, can cause a rash or lesions on the skin, including the neck.
- Kawasaki disease: An acute febrile illness that can cause a rash, fever, and lymphadenopathy, often affecting children and adolescents.
Rare diagnoses
- Pityriasis rosea: A rare skin condition characterized by a rash with a "herald patch" followed by a secondary eruption of smaller patches.
- Sarcoidosis: A systemic disease that can cause skin lesions, including on the neck, although it is rare in adolescents.
- Dermatomyositis: A rare autoimmune disease that can cause skin rash and muscle weakness, often affecting the face, neck, and extremities.