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Feature Article

Scaly red plaques in children: differential diagnoses and treatment

David Orchard
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Scaly red plaques are a common presentation in children and an accurate diagnosis is often sufficient on history and examination alone. The main differential diagnoses include discoid eczema, psoriasis, tinea corporis and pityriasis rosea. This article focuses on how to diagnose and treat each of these conditions.

Key Points

  • The most common differential diagnoses of a presentation of red scaly plaques are discoid eczema, psoriasis, tinea corporis and pityriasis rosea.
  • Discoid eczema is common and tends to be very pruritic.
  • Psoriasis is well-demarcated, is a salmon-pink colour and has a silvery scale.
  • There is usually a history of expansion of circular lesions with tinea corporis.
  • Pityriasis rosea patches tend to have an internal scale.
  • A biopsy can be helpful to aid with the diagnosis of children with red scaly plaques in difficult clinical situations.