Differential Diagnosis for Erythema and Scaling on Back of Scalp in a 16-year-old
- Single most likely diagnosis
- Seborrheic dermatitis: This condition is common in adolescents and young adults, characterized by erythema and scaling, particularly on the scalp. It's often associated with oily skin and can be exacerbated by stress, cold weather, and certain products.
- Other Likely diagnoses
- Psoriasis: Psoriasis can present with erythema and scaling on the scalp, and it's not uncommon in teenagers. It may be associated with other skin lesions or a family history of psoriasis.
- Dandruff (Pityriasis simplex): A mild form of seborrheic dermatitis, dandruff is very common and presents with fine, white scales on the scalp.
- Contact dermatitis: This could be due to an allergic reaction or irritant from hair products, leading to erythema and scaling on the scalp.
- Tinea capitis (Ringworm of the scalp): A fungal infection that can cause erythema, scaling, and hair loss, more common in children but can occur in teenagers.
- Do Not Miss (ddxs that may not be likely, but would be deadly if missed.)
- Cutaneous T-cell lymphoma (Mycosis fungoides): Although rare, this condition can present with skin lesions, including on the scalp, and is critical to diagnose early due to its potential for severe outcomes.
- Sarcoidosis: A systemic disease that can cause skin lesions, including on the scalp, and requires early diagnosis and treatment to prevent long-term complications.
- Rare diagnoses
- Keratosis follicularis (Darier's disease): A rare genetic disorder that affects the skin, including the scalp, causing erythema and scaling.
- Lichen planopilaris: An autoimmune condition that can lead to scalp inflammation, erythema, and scaling, along with hair loss.
- Discoid lupus erythematosus: A chronic skin condition of sores with inflammation and scarring favoring the face, ears, and scalp but can be widespread.