Differential Diagnosis for Pediatric Tender Scalp
Single Most Likely Diagnosis
- Traction alopecia or hair pulling: This condition is common in children, especially those with long hair, and can cause tenderness on the scalp without redness or fever.
Other Likely Diagnoses
- Lice infestation: Although lice infestation can cause redness and itching, some children may only experience tenderness on the scalp.
- Dandruff or seborrheic dermatitis: These conditions can cause scalp tenderness, but may not always be accompanied by redness or fever.
- Psoriasis: Psoriasis can cause scalp tenderness, and while it often presents with redness, some cases may not have this symptom.
Do Not Miss Diagnoses
- Meningitis: Although meningitis typically presents with fever, headache, and stiff neck, some cases may have atypical presentations, including scalp tenderness without redness or fever.
- Osteomyelitis of the skull: This rare but serious condition can cause scalp tenderness and may not always be accompanied by redness or fever.
- Subperiosteal abscess: This condition can cause scalp tenderness and may not always have accompanying redness or fever.
Rare Diagnoses
- Kerion: A rare complication of tinea capitis (ringworm of the scalp) that can cause scalp tenderness, but is often accompanied by redness and swelling.
- Aplasia cutis congenita: A rare congenital condition that can cause scalp defects and tenderness.
- Langerhans cell histiocytosis: A rare condition that can cause scalp tenderness, but often presents with other systemic symptoms.