Differential Diagnosis for Epidermal Verucous Nevus of Scalp in a 5-Month-Old Baby
Single Most Likely Diagnosis
- Epidermal nevus: This is the most likely diagnosis given the description of an epidermal verucous nevus. Epidermal nevi are benign growths that can appear as verucous (wart-like) lesions and are often present at birth or appear during early childhood.
Other Likely Diagnoses
- Inflammatory linear verrucous epidermal nevus (ILVEN): This condition presents with linear, inflammatory, and verrucous lesions, often on the extremities, but can also appear on the scalp. It's more common in females and usually appears in early childhood.
- Linear epidermal nevus: While similar to epidermal nevus, linear epidermal nevi follow the lines of Blaschko and can appear as verucous or flat lesions. They are also benign but can be part of a syndrome in some cases.
- Seborrheic keratosis: Although less common in infants, seborrheic keratoses can appear as verucous lesions. However, they are typically seen in older children and adults.
Do Not Miss Diagnoses
- Malignant tumors (e.g., basal cell carcinoma, squamous cell carcinoma): Although extremely rare in infants, any new or changing skin lesion warrants consideration of malignant processes, especially if there are atypical features or rapid growth.
- Infectious causes (e.g., warts, molluscum contagiosum): These can present as verucous lesions and are important to consider due to their potential for spread and the need for specific treatments.
- Congenital melanocytic nevus: While typically pigmented, some congenital melanocytic nevi can have a verucous appearance, especially if they are proliferative. Given the potential for malignant transformation, it's crucial not to miss this diagnosis.
Rare Diagnoses
- Nevus sebaceus of Jadassohn: A congenital skin lesion that can appear as a yellowish or orange plaque, often on the scalp. It has the potential for malignant transformation later in life.
- Epidermal nevus syndrome: A rare condition where epidermal nevi are associated with neurological, skeletal, or other systemic abnormalities. The presence of systemic symptoms or multiple lesions might suggest this diagnosis.
- Childhood linear IgA disease: An autoimmune condition that can present with blistering skin lesions, which might occasionally be mistaken for verucous lesions. It's rare and would typically have other distinctive features.