Peds Dermatology

Acne vulgaris 


Androgenetic alopecia


Atopic dermatitis (Eczema)

James Heilman, MD, CC BY-SA 3.0, via Wikimedia Commons
Pattern of atopic eczema varies with age
Madhero88, CC BY-SA 3.0, via Wikimedia Commons


Congenital syphilis

  • Presentation:
    • Copper-colored scaly macules and papules or moist erosions. Lesions are present at or after birth and seen in the diaper area and/or around the mouth and nose.
    • Condyloma lata – perianal papular lesions
      skin lesions contain spirochetes and are highly infectious
    • Other manifestations: symmetric desquamation of palms and soles, anemia, hepatosplenomegaly, jaundice, and changes of the long bones.
  • Diagnosis:

Contact dermatitis

  • Path:
    • Type IV hypersensitivity reaction to agents that come in contact with the skin
  • Presentation:
    • with inflammatory papules, vesicles, weeping or crusting.
    • Usually, intense pruritis, prominent scale, and lesions fail to improve with antibiotic therapy
    • Burning sensation if it irritant contact dermatitis
    • Eczematous (irritant) or vesicular (allergic)
Poison Ivy
Poision Ivy 2012
Alborz Fallah, CC BY-SA 3.0, via Wikimedia Commons

Dermatophyte Infections

Diaper dermatitis

Erythema infectiosum (5ths disease)

Erythema multiforme

Hand foot and mouth disease

  • Path:
    • Coxsackie A virus. Spread fecal orally and orally.
    • Usually occur in those less than 5 and in summer and fall
  • Presentation:
    • Clinical syndrome characterized by an oral enanthem and a macular, maculopapular, or vesicular rash on an erythematous base of the hands and feet
    • *Rash generally starts out as macules that progress to vesicles surrounded by erythema. Vesicles rupture and form ulcers with grey-yellow base
    • Non-pruritic and generally not painful. Lesions resolve in 3-4 days.
    • Symptoms include mild fever, URI symptoms, decrease appetite starting 3-5 days post-exposure
  • Complications:



Langerhans cell histiocytosis

  • Etiology:
    • heme/oncology condition.
    • Severe diaper dermatitis.
    • Cutaneous lesions have red/orange or yellow/brown scaly papules, erosions, or petechiae.
    • It can resemble seborrheic dermatitis but the color of lesions and the presence of petechiae differentiate.
    • They also have bone lesions, lymphadenopathy, hepatosplenomegaly, and anemia.
  • Diagnosis:

Lice (Pediculosis)

Lichen planus


Molluscum contagiosum


Neonatal acne

  • Presentation:
    • Inflammatory papules and pustules located mainly on the forehead, nose, and cheeks. No true comedones (blackheads or whiteheads)
    • Usually a result of inflammatory reaction to Pityrosporum (Malassezia) species
    • Presents around 2nd and 3rd week of life and resolves around 6-12 months of age.
  • Treatment:
    • * Self-limited. Some patients may benefit from topical antifungals.


Perioral dermatitis

Pigmented Lesions

Pityriasis rosea

Rubeola (measles)


  • Path:
    • 6th disease. Caused by HHV 6 usually. Sometimes HHV 7, coxsackieviruses A and B.
  • Presentation:
    • 90% of cases in those under 2 years old. Most between 7 and 13 months.
    • High fever for 3-5 days then fever decrease coincides with a rash
    • Rose pink maculopapular blanchable rash on trunk/back -> face
    • *ONLY viral exanthem that starts on the trunk and spreads to the face
    • Malaise, palpebral conjunctivitis, edematous eyelids, inflammation of the tympanic membranes, uvulopalatoglossal junctional macules or ulcers (Nagayama spots), upper or lower respiratory symptoms, vomiting, diarrhea, lymphadenopathy
    • High fever and bulging fontanelle usually results in evaluation for possible meningitis
    • Sterile pyuria – may be diagnosed with UTI
  • Complications: 
  • Transmission:
    • Spread by respiratory droplets, 10 day incubation period.
  • Treatment:
    • – supportive, anti-inflammatories

Rubella (German measles)

Scabies (Sarcopetes scabei)


Tinea versicolor




Viral Exanthems

Drug eruptions



  • Presentation:
    • Symmetrical drug-related intertriginous and flexural exanthema.
    • Occurs a few hours to a few days after the administration of the offending drug.
    • Usually appears as demarcated V-shaped erythema in gluteal/perigenital area and involvement of at least 1 other flexural or intertriginous fold
  • Treatment:
    • Amoxicillin, ceftriaxone, penicillin, clindamycin, and erythromycin involved in 50% of cases.


Stevens-Johnson syndrome

Toxic epidermal necrolysis

Rashes that affect palms and soles