Differential Diagnosis for Discrete, Smooth, Pink and Flesh-Colored, Dome-Shaped Papules in Infants
Single Most Likely Diagnosis
- Molluscum Contagiosum: This is a common viral infection in infants and young children, characterized by discrete, smooth, and flesh-colored papules. The dome-shaped appearance is typical, and the condition is often seen in this age group.
Other Likely Diagnoses
- Warts (Verruca): Caused by the human papillomavirus (HPV), warts can appear as flesh-colored, dome-shaped papules. They are contagious and can spread through skin-to-skin contact.
- Keratosis Pilaris: A benign condition that causes small, rough, sandpapery patches or papules on the skin, often on the arms, legs, buttocks, and cheeks. While not typically dome-shaped, the papules can sometimes appear smooth and flesh-colored.
- Erythema Toxicum Neonatorum (if presenting later than usual): Although typically seen in the first few days of life, some cases might present later, appearing as small, yellowish or flesh-colored papules or pustules.
Do Not Miss Diagnoses
- Langerhans Cell Histiocytosis: A rare disorder in which the body accumulates too many immature Langerhans cells, part of the immune system. Skin lesions can be variable but may include papules. This condition is critical to identify due to its potential systemic involvement and serious complications.
- Congenital Syphilis: Can cause a variety of skin manifestations, including papules. Given the potential for severe and long-term consequences if untreated, syphilis must be considered in the differential diagnosis.
Rare Diagnoses
- Juvenile Xanthogranuloma: A rare, benign condition that can cause skin lesions, including papules. These lesions are typically yellowish but can appear flesh-colored, especially in early stages.
- Nevus Lipomatosus Cutaneous Superficialis: A rare congenital condition characterized by soft, flesh-colored papules or nodules. It's essential to consider this in the differential for unusual skin findings in infants.