Differential Diagnosis for Rash on the Face of a 2-Month-Old

Single Most Likely Diagnosis

• Erythema Toxicum Neonatorum: A common, benign condition in newborns, characterized by small, yellow or white bumps on a red base, often appearing on the face, trunk, and extremities. It typically resolves on its own within the first week of life but can persist.

Other Likely Diagnoses

• Atopic Dermatitis (Eczema): Although it can start at any age, eczema often begins in infancy, presenting as red, itchy, and scaly patches on the face, scalp, and extremities. Family history of atopy increases the likelihood.
• Seborrhoeic Dermatitis: A condition causing a rash on the scalp (cradle cap), face (especially around the nose, eyebrows, and eyelids), and diaper area. It's common in infants and usually resolves by 6-12 months.
• Contact Dermatitis: An allergic or irritant reaction to substances like soaps, lotions, or other products coming into contact with the skin, leading to redness, itching, and small bumps.
• Milialia (Baby Acne): Caused by blocked oil glands, it presents as small, white bumps on the nose, chin, and forehead, often due to maternal hormone exposure.

Do Not Miss Diagnoses

• Congenital Infections (e.g., Congenital Syphilis, Rubella, or Toxoplasmosis): These can present with a variety of skin manifestations, including rashes, and are critical to diagnose due to their potential for serious complications.
• Herpes Simplex Virus (HSV) Infection: Can cause severe illness in newborns, with skin, eye, and mouth lesions being common presentations.
• Staphylococcal Scalded Skin Syndrome (SSSS): A serious condition caused by staphylococcal toxins that lead to widespread skin blistering and peeling, often starting on the face.

Rare Diagnoses

• Incontinentia Pigmenti: A genetic disorder that affects the skin, hair, teeth, nails, and central nervous system, presenting with characteristic skin lesions that evolve over time.
• Epidermolysis Bullosa: A group of genetic conditions that result in fragile skin and blisters, often appearing 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.