Differential Diagnosis for 8-Day-Old Infant with Rash on Face
Single Most Likely Diagnosis
- Erythema Toxicum Neonatorum: This is a common, benign condition that appears as a rash on the face and body of newborns, typically within the first few days of life. It is characterized by small, yellow or white bumps on a red base and resolves spontaneously.
Other Likely Diagnoses
- Acne Neonatorum: Also known as neonatal acne, this condition is thought to be caused by exposure to maternal hormones and can appear as small, inflammatory papules on the face, particularly the nose, chin, and forehead.
- Milia: These are small, white bumps that appear on the nose and face of newborns due to the blockage of oil glands. They are very common and resolve on their own.
- Seborrhoeic Dermatitis (Cradle Cap): Although more commonly associated with a scalp rash, seborrhoeic dermatitis can also affect the face, causing a red, oily, scaly rash.
Do Not Miss Diagnoses
- Congenital Infections (e.g., Congenital Syphilis, Rubella, CMV): These infections can cause a variety of skin manifestations, including rashes, and are critical to diagnose early due to their potential for serious complications.
- Herpes Simplex Virus (HSV) Infection: Neonatal HSV can present with skin, eye, or mouth lesions and is a medical emergency requiring prompt antiviral treatment.
- Staphylococcal Scalded Skin Syndrome (SSSS): Caused by staphylococcal toxins, SSSS can present with tender, erythematous skin and bullae, particularly in areas where the skin touches, such as the face.
Rare Diagnoses
- Incontinentia Pigmenti: A rare genetic disorder that can cause skin lesions, including a rash, typically following the lines of Blaschko.
- Epidermolysis Bullosa: A group of rare genetic conditions that result in fragile skin and blisters, which can appear at birth or shortly after.
- Langerhans Cell Histiocytosis: A rare disorder in which the body accumulates too many immature Langerhans cells, leading to a variety of symptoms, including skin rashes.