Differential Diagnosis for a Child with Nail Polish on Her Face

• Single most likely diagnosis:
  • Accidental ingestion or exposure to nail polish, leading to potential chemical exposure or irritant contact dermatitis. This is the most likely diagnosis given the context of the question, as nail polish contains chemicals that can cause skin irritation or other adverse effects if ingested or if they come into contact with the skin or eyes.
• Other Likely diagnoses:
  • Allergic contact dermatitis: An allergic reaction to one of the components in the nail polish, which could cause a rash, itching, or blistering on the skin where the polish came into contact.
  • Irritant contact dermatitis: Direct irritation from the chemicals in the nail polish, leading to redness, itching, or burning sensations on the skin.
  • Chemical conjunctivitis or keratitis: If the nail polish came into contact with the child's eyes, it could cause irritation or damage to the conjunctiva or cornea.
• Do Not Miss diagnoses:
  • Systemic toxicity from ingestion: Although less likely if the question only mentions the polish being on the face, there's a possibility the child ingested some, which could lead to systemic effects depending on the ingredients and amount ingested.
  • Corneal abrasion or ulcer: If the nail polish or its removal caused a scratch or damage to the cornea, which could lead to serious complications if not properly treated.
• Rare diagnoses:
  • Nail polish remover toxicity: If the child was exposed to nail polish remover in an attempt to clean the polish off, which contains acetone and can be toxic.
  • Dye or pigment-related reactions: Certain dyes in the nail polish could potentially cause more severe reactions, although this would be uncommon.