Differential Diagnosis for Pediatric Rash on Face
Single Most Likely Diagnosis
- Insect Bite Allergy or Contact Dermatitis: Given the symptoms of raised bumps, burning, itching, and swelling on the face, and considering the geographical location of southeast Missouri, an allergic reaction to insect bites (e.g., mosquitoes, ticks, or chiggers) or contact dermatitis (from plants like poison ivy, oak, or sumac) is highly plausible. The region's flora and fauna make such exposures common.
Other Likely Diagnoses
- Eczema (Atopic Dermatitis): This condition is characterized by itchy, inflamed skin and can present with raised bumps. It's common in children and can be exacerbated by environmental factors.
- Impetigo: A contagious bacterial skin infection that can cause red sores, bumps, and itching. It's common in children and can spread quickly.
- Allergic Contact Dermatitis: An allergic reaction to substances like nickel, certain chemicals in cosmetics, or latex can cause a rash with similar symptoms.
Do Not Miss Diagnoses
- Cellulitis: A bacterial skin infection that can cause redness, swelling, and warmth. It requires prompt antibiotic treatment to prevent serious complications.
- Lyme Disease: Given the geographical location, Lyme disease (transmitted by tick bites) is a critical diagnosis not to miss. Early stages can present with a characteristic "bull's-eye" rash, but not all cases present classically.
- Stevens-Johnson Syndrome (SJS) or Toxic Epidermal Necrolysis (TEN): These are severe skin conditions usually triggered by medications or infections. They can present with skin lesions, blisters, and detachment of the skin, which can be life-threatening.
Rare Diagnoses
- Pemphigus: A group of rare skin disorders that cause blistering of the skin and mucous membranes. It's autoimmune in nature and can be life-threatening if not treated.
- Kawasaki Disease: An illness that affects children and causes inflammation in the walls of medium-sized arteries throughout the body. It can present with a rash, among other symptoms like fever, swollen lymph nodes, and changes in the mouth and hands and feet.
- Erythema Multiforme: An immune-mediated disorder that can be triggered by infections or medications, characterized by target-like lesions on the skin. It can range from mild to severe.