Differential Diagnosis for Honey Crusted Lesions near Mouth and on Eyelid in a 3-year-old
- Single most likely diagnosis
- Impetigo: This is a highly contagious bacterial skin infection that commonly presents with honey-crusted lesions, especially around the mouth and nose. The age of the patient and the description of the lesions make impetigo the most likely diagnosis.
- Other Likely diagnoses
- Eczema (Atopic Dermatitis) with secondary infection: While eczema itself doesn't typically present with honey-crusted lesions, it can become secondarily infected with bacteria like Staphylococcus aureus, leading to similar appearances.
- Herpes Simplex Virus (HSV) infection: Though typically vesicular, in the healing phase or with secondary bacterial infection, HSV lesions can appear crusted.
- Do Not Miss (ddxs that may not be likely, but would be deadly if missed.)
- Meningococcemia: Although rare, this condition can present with skin lesions and is life-threatening. The presence of lesions, especially if accompanied by other symptoms like fever, should prompt consideration of this diagnosis.
- Staphylococcal Scalded Skin Syndrome (SSSS): Caused by staphylococcal toxins, SSSS can present with skin lesions and is more common in children. It requires prompt recognition and treatment.
- Rare diagnoses
- Congenital Syphilis: Can present with a variety of skin manifestations, including lesions around the mouth and eyes, though this would be unusual without other systemic signs.
- Histoplasmosis or other fungal infections: Though less common, fungal infections can cause skin lesions, and in immunocompromised patients, these should be considered, especially if the patient has been exposed to soil or birds.