Differential Diagnosis for Vesicular Rash in a 2-year-old
- Single most likely diagnosis
- Varicella (Chickenpox): This is the most common cause of a vesicular rash in children, characterized by a pruritic, vesicular rash that progresses from the trunk to the extremities, often accompanied by fever and malaise.
- Other Likely diagnoses
- Herpes Simplex Virus (HSV) infection: Can cause a vesicular rash, especially on the face, hands, or genital area, and is often accompanied by fever and irritability.
- Hand, Foot, and Mouth Disease (HFMD): Typically caused by Coxsackievirus A or Enterovirus 71, characterized by a vesicular rash on the hands, feet, and mouth, often accompanied by fever and sore throat.
- Impetigo: A bacterial infection of the skin that can cause vesicles, especially on the face, and is often accompanied by honey-colored crusts.
- Do Not Miss (ddxs that may not be likely, but would be deadly if missed.)
- Staphylococcal Scalded Skin Syndrome (SSSS): A life-threatening condition caused by staphylococcal toxins that can cause widespread skin lesions, including vesicles, and is often accompanied by fever and irritability.
- Toxic Epidermal Necrolysis (TEN): A severe skin condition that can cause widespread skin lesions, including vesicles, and is often accompanied by fever, irritability, and mucous membrane involvement.
- Rare diagnoses
- Incontinentia Pigmenti: A rare genetic disorder that can cause a vesicular rash, especially in newborns, and is often accompanied by other systemic symptoms such as seizures and developmental delays.
- Acute Hemorrhagic Edema of Infancy: A rare condition that can cause a vesicular rash, especially on the face and extremities, and is often accompanied by fever and irritability.