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 tender scalp without redness, fever, or lymphadenopathy due to hair follicle stress or breakage.
Other Likely Diagnoses
- Folliculitis: An inflammation of the hair follicles, often caused by bacterial or fungal infections, which can lead to a tender scalp.
- Pediatric scalp dermatitis: Conditions like eczema or contact dermatitis can cause scalp tenderness in children.
- Head lice: Infestation with head lice can cause scalp tenderness, especially if the child has an allergic reaction to the lice bites.
Do Not Miss Diagnoses
- Meningitis: Although less likely, meningitis can present with scalp tenderness, especially if there is inflammation of the meninges that affects the scalp.
- Osteomyelitis of the skull: A rare but serious infection of the skull bone that can cause scalp tenderness and should not be missed.
- Neuroblastoma with scalp metastasis: A rare childhood cancer that can metastasize to the scalp, causing tenderness.
Rare Diagnoses
- Kerion: A rare, severe form of tinea capitis (ringworm of the scalp) that can cause scalp tenderness and inflammation.
- Alopecia areata: An autoimmune condition that causes hair loss and can be associated with scalp tenderness in some cases.
- Scalp abscess: A rare, localized collection of pus on the scalp that can cause tenderness and should be considered in the differential diagnosis.