Differential Diagnosis for Multiple Small Pustules on a Toddler's Head
- Single Most Likely Diagnosis
- Impetigo: This is a highly contagious bacterial skin infection common in children, characterized by small pustules or vesicles that rupture and form a honey-colored crust. The justification for this being the most likely diagnosis is its prevalence in toddlers and the typical presentation of small pustules.
- Other Likely Diagnoses
- Eczema (Atopic Dermatitis): While eczema is more associated with itchy, inflamed skin, it can sometimes present with small pustules, especially if there's a secondary bacterial infection. The age of the patient and the location on the head make this a plausible diagnosis.
- Folliculitis: An inflammation of the hair follicles, which can be caused by bacterial or fungal infections. It presents as small, pus-filled bumps and is common in areas with hair, such as the scalp.
- Seborrheic Dermatitis: This condition can cause scaly patches, red skin, and stubborn dandruff, and sometimes small pustules, especially in infants and young children.
- Do Not Miss Diagnoses
- Meningitis: Although the primary symptoms of meningitis are fever, headache, and stiff neck, in very young children or infants, the presentation can be atypical, including rash. It's crucial to consider this diagnosis due to its high mortality rate if untreated.
- Staphylococcal Scalded Skin Syndrome (SSSS): Caused by staphylococcal toxins, SSSS can present with widespread blistering and peeling of the skin, starting with small pustules or redness. It's a medical emergency.
- Rare Diagnoses
- Kerion: A severe form of tinea capitis (ringworm of the scalp), which can cause pustules, redness, and swelling, along with hair loss.
- Autoimmune disorders: Such as pemphigus or pemphigoid, which are rare in toddlers but can cause blistering or pustular skin lesions.
- Congenital or genetic conditions: Certain conditions like epidermolysis bullosa can cause blistering or pustular lesions, though these are typically identified at birth or shortly after.