Differential Diagnosis for a 6-year-old with Little Bumps on the Chin
- Single most likely diagnosis:
- Keratosis Pilaris: A common, harmless condition characterized by small, rough bumps on the skin, often on the cheeks, chin, and arms. It's more noticeable in dry environments and tends to improve with moisturizing.
- Other Likely diagnoses:
- Acne: Early onset acne can present as small bumps or comedones on the face, including the chin. It's becoming increasingly common in pre-teens due to hormonal changes.
- Molluscum Contagiosum: A viral skin infection that causes small, pearly, or flesh-colored bumps. It's contagious and common in children, often spread by skin-to-skin contact or through contaminated objects.
- Folliculitis: An inflammation of the hair follicles, which can appear as small bumps or pus-filled pimples, often due to bacterial or fungal infections.
- Do Not Miss (ddxs that may not be likely, but would be deadly if missed.):
- Tuberculosis (TB): Although rare, TB can manifest with skin lesions, including on the face. Given its severity and the importance of early treatment, it should not be overlooked, especially in areas with high TB prevalence or in children with compromised immune systems.
- Histoplasmosis: A fungal infection that can cause skin lesions among other symptoms. It's more common in certain geographic areas and can be severe in immunocompromised individuals.
- Rare diagnoses:
- Sarcoidosis: A condition that can cause small bumps or lesions on the skin, including the face, due to the formation of granulomas. It's rare in children and often involves other organs.
- Langerhans Cell Histiocytosis (LCH): A rare disorder in which the body accumulates too many immature Langerhans cells, leading to a variety of symptoms, including skin lesions. It's more common in younger children and can be severe.