Differential Diagnosis for a 4-week-old with Cephalic Pustulosis
- Single most likely diagnosis:
- Erythema toxicum neonatorum: This is a common, benign condition that presents with small, yellow or white bumps on a red base, often on the face, and can appear in the first few weeks of life.
- Other Likely diagnoses:
- Acne neonatorum: This condition is caused by exposure to maternal hormones and can present with comedones, papules, and pustules, primarily on the face.
- Milia: These are small, white bumps that result from keratin accumulation in the skin and are very common in newborns.
- Do Not Miss (ddxs that may not be likely, but would be deadly if missed.):
- Congenital syphilis: Although less common, this condition can present with a variety of skin manifestations, including bullous or pustular lesions, and is critical to diagnose due to its severe consequences if left untreated.
- Herpes simplex virus infection: Neonatal HSV can present with skin, eye, or mouth lesions and is a medical emergency requiring prompt antiviral treatment.
- Rare diagnoses:
- Langerhans cell histiocytosis: A rare disorder that can present with skin lesions, among other systemic symptoms, and requires early diagnosis and treatment.
- Congenital leukemia: An extremely rare condition that can cause skin lesions, among other symptoms, and necessitates immediate medical intervention.