What is the cause of recurrent localized erythema (redness) of the cheek in a 2-year-old child?

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Last updated: April 22, 2025View editorial policy

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Differential Diagnosis for a 2-year-old with Recurrent Localized Red Cheek

  • Single most likely diagnosis:
    • Slapped cheek syndrome (Erythema infectiosum): This is a common condition in children, caused by parvovirus B19, characterized by a distinctive "slapped cheek" appearance, which fits the description of a recurrent localized red cheek.
  • Other Likely diagnoses:
    • Eczema (atopic dermatitis): This is a chronic skin condition that can cause redness and inflammation, often affecting the cheeks in young children.
    • Allergic contact dermatitis: An allergic reaction to substances like food, cosmetics, or environmental factors can cause localized redness and inflammation on the cheek.
    • Impetigo: A contagious bacterial skin infection that can cause red sores on the face, including the cheeks.
  • Do Not Miss (ddxs that may not be likely, but would be deadly if missed.):
    • Cellulitis: A bacterial skin infection that can cause redness, swelling, and warmth, which requires prompt antibiotic treatment to prevent serious complications.
    • Lupus: Although rare in children, systemic lupus erythematosus can cause a "butterfly" rash on the cheeks, and missing this diagnosis could have severe consequences.
  • Rare diagnoses:
    • Sarcoidosis: A condition that can cause skin lesions, including on the face, although it is rare in young children.
    • Juvenile idiopathic arthritis: Some forms of this condition can cause skin rashes, including on the cheeks, but this would be accompanied by other systemic symptoms.

Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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